Clip-traction vs Standard colorectal ESD: a randomized controlled trial Travel Award

Background: Endoscopic submucosal dissection (ESD) for colorectal lesions may be facilitated by various traction techniques. This study evaluated whether clip–traction improves resection speed compared to standard colorectal ESD. A total of 230 patients were enrolled.
Method: Patients were randomized to undergo either clip–traction or standard ESD. The primary endpoint was resection speed (cm²/min). Lesion size (cm²) was measured and included as a covariate in linear and quantile regressions. Subgroup analyses based on lesion size categories were also performed.
Results: At this interim analysis (N=230), median lesion size was 12,9 cm² (1.2-165). Linear regression showed a strong association between lesion size and resection speed (p=0.003). However, no significant difference in resection speed was seen between standard and clip–traction ESD (p=0.83). Interaction terms indicated no differential effect of clip–traction across varying lesion sizes (p=0.76). Quantile regression showed similar findings at the 25th, 50th and 75th percentiles, suggesting that the lack of difference was consistent across the resection speed distribution. No difference of clip–traction effect could be seen when stratifying by lesion location.
Conclusion: In this randomized controlled trial, clip–traction did not significantly alter resection speed compared to standard colorectal ESD. These results suggest that clip–traction may not provide a procedural advantage in terms of resection speed for colorectal ESD.