International Session(Workshop)3(JGES・JSGE・JSGS・JSGCS)
Sat. November 4th   14:00 - 16:30   Room 11: Portopia Hotel South Wing Topaz
Efficacy of traction-assisted endoscopic submucosal dissection as a rescue method to overcome technical difficulty
Shion Tachibana1, Keitaro Takahashi1, Mikihiro Fujiya1
1Gastroenterology and Endoscopy, Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Asahikawa Medical University
Background: Traction–assisted ESD makes the procedure time shorter. However, it is unclear whether the traction device is useful as a rescue method for difficult colorectal ESD, comparing with conversion to snare resection (rescue–snare ESD: rSnare). We presented the first study that compared the efficacy of rSnare and rescue–traction–assisted ESD (rTraction).
Methods: This study included 46 lesions treated with rSnare and 39 lesions treated with rTraction. The clinicopathological features were analyzed.
Results: The en bloc resection rate was 43.5% (20/46) in the rSnare group and 94.9% (37/39) in the rTraction group (p<0.05). The procedure time was 110.7 ± 61.4 min in the rSnare group and 170.5 ± 77.8 min in the rTraction group (p<0.05). The tumor size over 30 mm (OR 13.50, 95% CI 1.31–140.0, p = 0.03) and traction time over 90 min (OR 9.00, 95% CI 1.62–50.10, p = 0.01) were independent factors in the multivariate analyses for factors of longer procedure time in the rTraction group.
Conclusions: The rTraction showed a higher en bloc resection rate in the difficult colorectal ESD than the rSnare, suggesting that the rTraction should be the first choice of rescue method for the difficult ESD. Using the traction device within 90 min may result in shortening the procedure time, especially for colorectal lesions more than 30 mm.
Index Term 1: colorectal ESD
Index Term 2: Traction-assisted ESD
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