Japan Digestive Disease Week 2025
Strategic International Session3 (W) (JGES, JSGE, JSGS)
November 01, 14:30–17:00, Room 9 (Portopia Hotel Main Building Kairaku 3)
ST3-3_E
Evaluation of Vascular and Muscular Layer Visibility in Colorectal Endoscopic Submucosal Dissection Using Amber-red Color Imaging
- 1
- Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine
Background
Amber-red Color Imaging (ACI:Fujifilm) is a newly developed imaging mode that enhances vascular visualization. This pilot study aimed to evaluate the improvement in visibility of blood-vessels and the proper muscle layer using ACI during colorectal-ESD and to assess its potential contribution for preventing perioperative bleeding and massive coagulation of muscle-layer.
Methods
This study included the patients underwent colorectal-ESD at our institution after December 2024, in whom both white light imaging (WLI) and ACI observations were performed. The study assessed treatment outcomes and compared the visibility of blood-vessels, submucosal-layer, and muscle-layer between WLI and ACI during submucosal dissection, using a four-point score (4:excellent, 3:good, 2:fair, 1:poor).
Results
Twenty cases were analyzed, with a mean tumor size of 27.0±8.7mm. The mean procedure time was 59.4±43.8 minutes, with a 90.0% en-bloc-resection rate. Histopathology showed 20 neoplasms including 3 T1 cancers. ACI showed significantly higher visibility scores than WLI for blood-vessels (3.7±0.6 vs. 2.6±0.6, p<0.01), the submucosal-layer (3.5±0.6 vs. 2.9±0.7, p<0.01), and the muscle-layer (3.3±0.9 vs. 2.2±0.7, p<0.01). Similar trends were observed among nonexpert-endoscopists and clinical-technicians. Among these 20 cases, there were fewer instances of intraoperative bleeding (3.2±2.8), with no massive coagulation of the muscle layer leading to delayed perforation.
Conclusions
ACI observation during colorectal-ESD significantly improved visibility of vessels and muscle-layer, suggesting its potential to enhance procedural safety and accuracy.
Amber-red Color Imaging (ACI:Fujifilm) is a newly developed imaging mode that enhances vascular visualization. This pilot study aimed to evaluate the improvement in visibility of blood-vessels and the proper muscle layer using ACI during colorectal-ESD and to assess its potential contribution for preventing perioperative bleeding and massive coagulation of muscle-layer.
Methods
This study included the patients underwent colorectal-ESD at our institution after December 2024, in whom both white light imaging (WLI) and ACI observations were performed. The study assessed treatment outcomes and compared the visibility of blood-vessels, submucosal-layer, and muscle-layer between WLI and ACI during submucosal dissection, using a four-point score (4:excellent, 3:good, 2:fair, 1:poor).
Results
Twenty cases were analyzed, with a mean tumor size of 27.0±8.7mm. The mean procedure time was 59.4±43.8 minutes, with a 90.0% en-bloc-resection rate. Histopathology showed 20 neoplasms including 3 T1 cancers. ACI showed significantly higher visibility scores than WLI for blood-vessels (3.7±0.6 vs. 2.6±0.6, p<0.01), the submucosal-layer (3.5±0.6 vs. 2.9±0.7, p<0.01), and the muscle-layer (3.3±0.9 vs. 2.2±0.7, p<0.01). Similar trends were observed among nonexpert-endoscopists and clinical-technicians. Among these 20 cases, there were fewer instances of intraoperative bleeding (3.2±2.8), with no massive coagulation of the muscle layer leading to delayed perforation.
Conclusions
ACI observation during colorectal-ESD significantly improved visibility of vessels and muscle-layer, suggesting its potential to enhance procedural safety and accuracy.
- Index Term 1: Colorectal ESD
- Index Term 2: ACI