Indications for Dental Floss Clip Traction During Gastric Endoscopic Submucosal Dissection by Less-Experienced Endoscopists.

IF 3.2 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastric Cancer Pub Date : 2023-10-01 DOI:10.5230/jgc.2023.23.e37

Hirosato Tamari, Shiro Oka, Takahiro Kotachi, Hajime Teshima, Junichi Mizuno, Motomitsu Fukuhara, Hidenori Tanaka, Akiyoshi Tsuboi, Ken Yamashita, Ryo Yuge, Yuji Urabe, Yasuhiko Kitadai, Koji Arihiro, Shinji Tanaka

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引用次数: 0

Abstract

Purpose: Dental floss clip (DFC) traction-assisted endoscopic submucosal dissection (ESD) is widely performed owing to its simplicity. This study aimed to clarify the appropriate indications for the DFC traction method in early gastric cancer when ESD is performed by less-experienced endoscopists.

Methods and methods: We retrospectively analyzed 1,014 consecutive patients who had undergone gastric ESD performed by less-experienced endoscopists between January 2015 and December 2020. Gastric ESD was performed without DFC in all cases before December 2017 [DFC (-) group, 376 cases], and ESD was performed with DFC in all cases after January 2018 [DFC (+) group, 436 cases]. The procedure time and rates of en bloc resection, complete resection, and adverse events of the groups were compared.

Results: The procedure time did not differ significantly between the 2 groups. However, when comparing lesions >20 mm, the procedure time in the DFC (+) group was significantly shorter than that in the DFC (-) group (95±46 vs. 75±31, P<0.01). The procedure time for lesions located in the greater curvature of the upper or middle stomach and lesions >20 mm located in the lesser curvature side of the stomach in the DFC (+) group was significantly shorter than that in the DFC (-) group.

Conclusions: The indications for DFC during gastric ESD by less-experienced endoscopists include lesions located in the greater curvature of the upper or middle stomach, and lesions >20 mm located in the lesser curvature of the stomach.

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经验不足的内窥镜医生在胃内窥镜粘膜下解剖过程中牙线夹牵引的适应症。

目的：牙线夹（DFC）牵引辅助内镜黏膜下剥离术（ESD）因其简单易行而被广泛应用。本研究旨在阐明当经验较少的内镜医生进行ESD时，DFC牵引方法在早期癌症中的适当适应症。方法和方法：我们回顾性分析了2015年1月至2020年12月期间由经验不足的内镜医生进行胃ESD的1014名连续患者。2017年12月之前，所有病例均在不使用DFC的情况下进行胃ESD[DFC（-）组，376例]，2018年1月之后，所有病例都使用DFC进行ESD[DFC组，436例]。比较两组的手术时间、整体切除率、完全切除率和不良事件。结果：两组患者的手术时间差异无统计学意义。然而，当比较>20mm的病变时，DFC（+）组的手术时间明显短于DFC（-）组（95±46 vs.75±31，DFC组位于胃小曲率侧的P20mm明显短于DFC（-）。结论：经验不足的内镜医生在胃ESD期间对DFC的适应症包括位于上胃或中胃大曲率的病变，以及位于胃小曲率>20mm的病变。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastric Cancer Biochemistry, Genetics and Molecular Biology-Cancer Research

CiteScore

4.30

自引率

12.00%

发文量

期刊介绍： The Journal of Gastric Cancer (J Gastric Cancer) is an international peer-reviewed journal. Each issue carries high quality clinical and translational researches on gastric neoplasms. Editorial Board of J Gastric Cancer publishes original articles on pathophysiology, molecular oncology, diagnosis, treatment, and prevention of gastric cancer as well as articles on dietary control and improving the quality of life for gastric cancer patients. J Gastric Cancer includes case reports, review articles, how I do it articles, editorials, and letters to the editor.