Bipolar-current needle-knife with a water jet function (Jet B-knife) shortens the procedure time of endoscopic submucosal dissection for colorectal tumors.
Ball-tip bipolar-current needle-knife
Colorectal tumor
Endoscopic submucosal dissection
Spray coagulation
Journal
Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
received:
08
10
2019
accepted:
16
07
2020
pubmed:
30
7
2020
medline:
30
9
2021
entrez:
30
7
2020
Statut:
ppublish
Résumé
Endoscopic submucosal dissection (ESD) is a technically difficult and time-consuming procedure for the treatment of large colorectal tumors. In Japan, the ball-tip bipolar-current needle-knife (BB-knife) has been used in ESD as a safe device that minimizes the damage to deeper tissues of colorectal neoplasms. In May 2012, a BB-knife combined with a water jet function (Jet B-knife) was newly developed. This retrospective study was aimed at examining the effectiveness and safety of the Jet B-knife. The BB-knife was used in 276 lesions (BB-knife group), while the Jet B-knife was used in 245 lesions (Jet B-knife group). We evaluated tumor characteristics and the results of the ESD procedures, including the size of the resected tumor, histological diagnosis, time required for resection, frequency of using other electrical devices, en bloc resection rate, and incidence rate of associated complications. Then, the data obtained were compared between the two groups. The histological evaluation of the resected tumors revealed that the incidence of cancer was not significantly different between the two groups. The median time required for resection was 103 min (45-255) in the BB-knife group and 51 min (28-210) in the Jet B-knife group. The difference was statistically significant (p < 0.05). Furthermore, the median tumor diameters were 23.1 mm (18-50) and 26.2 mm (20-60) in the BB-knife and Jet B-knife groups, respectively, demonstrating a statistically significant difference (p < 0.05). Multivariate logistic regression analysis revealed that short resection time (p < 0.001) and reduced use of hemostatic devices (p < 0.01) were independent favorable features of Jet B-knife. The en bloc resection rate and the perforation rate were not statistically significant between the two groups. Use of the Jet B-knife may contribute to the development of a time-saving, cost-effective, and safe procedure for ESD of colorectal tumors.
Sections du résumé
BACKGROUND
Endoscopic submucosal dissection (ESD) is a technically difficult and time-consuming procedure for the treatment of large colorectal tumors. In Japan, the ball-tip bipolar-current needle-knife (BB-knife) has been used in ESD as a safe device that minimizes the damage to deeper tissues of colorectal neoplasms. In May 2012, a BB-knife combined with a water jet function (Jet B-knife) was newly developed.
METHODS
This retrospective study was aimed at examining the effectiveness and safety of the Jet B-knife. The BB-knife was used in 276 lesions (BB-knife group), while the Jet B-knife was used in 245 lesions (Jet B-knife group). We evaluated tumor characteristics and the results of the ESD procedures, including the size of the resected tumor, histological diagnosis, time required for resection, frequency of using other electrical devices, en bloc resection rate, and incidence rate of associated complications. Then, the data obtained were compared between the two groups.
RESULTS
The histological evaluation of the resected tumors revealed that the incidence of cancer was not significantly different between the two groups. The median time required for resection was 103 min (45-255) in the BB-knife group and 51 min (28-210) in the Jet B-knife group. The difference was statistically significant (p < 0.05). Furthermore, the median tumor diameters were 23.1 mm (18-50) and 26.2 mm (20-60) in the BB-knife and Jet B-knife groups, respectively, demonstrating a statistically significant difference (p < 0.05). Multivariate logistic regression analysis revealed that short resection time (p < 0.001) and reduced use of hemostatic devices (p < 0.01) were independent favorable features of Jet B-knife. The en bloc resection rate and the perforation rate were not statistically significant between the two groups.
CONCLUSIONS
Use of the Jet B-knife may contribute to the development of a time-saving, cost-effective, and safe procedure for ESD of colorectal tumors.
Identifiants
pubmed: 32725477
doi: 10.1007/s00464-020-07832-w
pii: 10.1007/s00464-020-07832-w
doi:
Substances chimiques
Water
059QF0KO0R
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
3600-3606Références
Tanaka M, Ono H, Hasuike N et al (2008) Endoscopic submucosal dissection of early gastric cancer. Digestion 77(Suppl 1):23–28
doi: 10.1159/000111484
Oyama T, Tomori A, Hotta K et al (2005) Endoscopic submucosal dissection of early esophageal cancer. Clin Gastroenterol Hepatol 3(Suppl 1):67–70
doi: 10.1016/S1542-3565(05)00291-0
Saito Y, Uraoka T, Yamaguchi Y et al (2010) A prospective, multicenter study of 1111 colorectal endoscopic submucosal dissections (with video). Gastrointest Endosc 72:1217–1225
doi: 10.1016/j.gie.2010.08.004
Tanaka S, Kashida H, Saito Y et al (2015) JGES guidelines for colorectal endoscopic submucosal dissection/endoscopic mucosal resection. Dig Endosc 27:417–434
doi: 10.1111/den.12456
Fujishiro M, Yahagi N, Kakushima N et al (2007) Outcomes of endoscopic submucosal dissection for colorectal epithelial neoplasms in 200 consecutive cases. Clin Gastroenterol Hepatol 5:678–683
doi: 10.1016/j.cgh.2007.01.006
Honma K, Kobayashi M, Watanabe H et al (2010) Endoscopic submucosal dissection for colorectal neoplasia. Dig Endosc 22:307–311
doi: 10.1111/j.1443-1661.2010.01018.x
Hurlstone DP, Atkinson R, Sanders DS et al (2007) Achieving R0 resection in the colorectum using endoscopic submucosal dissection. Br J Surg 94:1536–1542
doi: 10.1002/bjs.5720
Iizuka H, Okamura S, Onozato Y et al (2009) Endoscopic submucosal dissection for colorectal tumors. Gastroenterol Clin Biol 33:1004–1011
doi: 10.1016/j.gcb.2009.02.039
Isomoto H, Nishiyama H, Yamaguchi N et al (2009) Clinicopathological factors associated with clinical outcomes of endoscopic submucosal dissection for colorectal epithelial neoplasms. Endoscopy 41:679–683
doi: 10.1055/s-0029-1214979
Matsumoto A, Tanaka S, Oba S et al (2010) Outcome of endoscopic submucosal dissection for colorectal tumors accompanied by fibrosis. Scand J Gastroenterol 45:1329–1337
doi: 10.3109/00365521.2010.495416
Nishiyama H, Isomoto H, Yamaguchi N et al (2010) Endoscopic submucosal dissection for laterally spreading tumours of the colorectum in 200 consecutive cases. Surg Endosc 24:2881–2887
doi: 10.1007/s00464-010-1071-5
Fusaroli P, Grillo A, Zanarini S et al (2009) Usefulness of a second endoscopic arm to improve therapeutic endoscopy in the lower gastrointestinal tract. Preliminary experience—a case series. Endoscopy 41:997–1000
doi: 10.1055/s-0029-1215190
Uraoka T, Kato J, Ishikawa S et al (2007) Thin endoscope-assisted endoscopic submucosal dissection for large colorectal tumors (with videos). Gastrointest Endosc 66:836–839
doi: 10.1016/j.gie.2007.04.028
Ishii N, Itoh T, Horiki N et al (2010) Endoscopic submucosal dissection with a combination of small-caliber-tip transparent hood and flex knife for large superficial colorectal neoplasias including ileocecal lesions. Surg Endosc 24:1941–1947
doi: 10.1007/s00464-010-0883-7
Kanamori A, Nakano M, Kondo M et al (2017) Clinical effectiveness of the pocket-creation method for colorectal endoscopic submucosal dissection. Endosc Int Open 5:E1299–E1305
doi: 10.1055/s-0043-118744
Yoshii S, Akasaka T, Hayashi Y et al (2018) “Underwater” endoscopic submucosal dissection: a novel method for resection in saline with a bipolar needle knife for colorectal epithelial neoplasia. Surg Endosc 32:5031–5036
doi: 10.1007/s00464-018-6278-x
Tanaka S, Toyonaga T, East J et al (2010) Endoscopic retrieval method using a small grip-seal plastic bag for large colorectal resection specimens after endoscopic submucosal dissection. Endoscopy 42(Suppl 2):E186–187
doi: 10.1055/s-0029-1244168
Toyonaga T, Man-i M, Chinzei R et al (2010) Endoscopic treatment for early stage colorectal tumors: the comparison between EMR with small incision, simplified ESD, and ESD using the standard flush knife and the ball tipped flush knife. Acta Chir Iugosl 57:41–46
doi: 10.2298/ACI1003041T
Harada A, Gotoda T, Fukuzawa M et al (2013) Clinical impact of endoscopic devices for colorectal endoscopic submucosal dissection. Digestion 88:72–78
doi: 10.1159/000352024
Suzuki T, Hara T, Kitagawa Y et al (2016) Usefulness of IT knife nano for endoscopic submucosal dissection of large colo-rectal lesions. Acta Gastroenterol Belg 79:186–190
pubmed: 27382935
Oka S, Tanaka S, Takata S et al (2012) Usefulness and safety of SB knife Jr in endoscopic submucosal dissection for colorectal tumors. Dig Endosc 24(Suppl 1):90–95
doi: 10.1111/j.1443-1661.2012.01255.x
Sano Y, Fu KI, Saito Y et al (2006) A newly developed bipolar-current needle-knife for endoscopic submucosal dissection of large colorectal tumors. Endoscopy 38(Suppl 2):E95
doi: 10.1055/s-2006-944622
Takeuchi Y, Uedo N, Ishihara R et al (2010) Efficacy of an endo-knife with a water-jet function (Flushknife) for endoscopic submucosal dissection of superficial colorectal neoplasms. Am J Gastroenterol 105:314–322
doi: 10.1038/ajg.2009.547
Hotta K, Oyama T, Shinohara T et al (2010) Learning curve for endoscopic submucosal dissection of large colorectal tumors. Dig Endosc 22:302–306
doi: 10.1111/j.1443-1661.2010.01005.x
Jeon HH, Lee HS, Youn YH et al (2016) Learning curve analysis of colorectal endoscopic submucosal dissection (ESD) for laterally spreading tumors by endoscopists experienced in gastric ESD. Surg Endosc 30:2422–2430
doi: 10.1007/s00464-015-4493-2
Watanabe T, Itabashi M, Shimada Y et al (2015) Japanese Society for Cancer of the Colon and Rectum. Japanese Society for Cancer of the Colon and Rectum (JSCCR) Guidelines 2014 for treatment of colorectal cancer. Int J Clin Oncol 20:207–239
doi: 10.1007/s10147-015-0801-z
Schlemper RJ, Riddell RH, Kato Y et al (2000) The Vienna classification of gastrointestinal epithelial neoplasia. Gut 47:251–255
doi: 10.1136/gut.47.2.251
Mori H, Kobara H, Nishiyama N et al (2017) Novel effective and repeatedly available ring-thread counter traction for safer colorectal endoscopic submucosal dissection. Surg Endosc 31:3040–3047
doi: 10.1007/s00464-016-5326-7
Yamasaki Y, Takeuchi Y, Uedo N et al (2017) Efficacy of traction-assisted colorectal endoscopic submucosal dissection using a clip-and-thread technique: a prospective randomized study. Dig Endosc 30:467–476
doi: 10.1111/den.13036
Sakamoto N, Osada T, Shibuya T et al (2009) Endoscopic submucosal dissection of large colorectal tumors by using a novel spring-action S–O clip for traction (with video). Gastrointest Endosc 69:1370–1374
doi: 10.1016/j.gie.2008.12.245
Ritsuno H, Sakamoto N, Osada T et al (2014) Prospective clinical trial of traction device-assisted endoscopic submucosal dissection of large superficial colorectal tumors using the S–O clip. Surg Endosc 28:3143–3149
doi: 10.1007/s00464-014-3572-0
Shiga H, Endo K, Kuroha M et al (2014) Endoscopic submucosal dissection for colorectal neoplasia during the clinical learning curve. Surg Endosc 28:2120–2128
doi: 10.1007/s00464-014-3443-8
Sakamoto T, Saito Y, Fukunaga S et al (2011) Learning curve associated with colorectal endoscopic submucosal dissection for endoscopists experienced in gastric endoscopic submucosal dissection. Dis Colon Rectum 54:1307–1312
doi: 10.1097/DCR.0b013e3182282ab0