Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
Gastrointest Endosc. 2012 Nov;76(5):1034-8. doi: 10.1016/j.gie.2012.07.013. Epub 2012 Aug 17.
Endoscopic submucosal dissection (ESD) can be used to perform resections en bloc for early-stage GI tumors. Pharyngeal ESD is less invasive, but technically difficult. Therefore, innovations to safely and easily perform this procedure are needed.
The aim of this study was to evaluate ESD under peroral countertraction, a new traction system for improving subepithelial cutting line visualization, compared with conventional ESD.
Retrospective study.
Toranomon Hospital, Tokyo, Japan.
A total of 93 patients (140 lesions) with superficial pharyngeal cancers treated with ESD were enrolled.
ESD under peroral countertraction or conventional ESD.
En bloc resection rate, size of the tumor, and procedure time.
All lesions were resected en bloc by using this technique. The mean longest lesion size was 23.4 mm in the peroral countertraction group and 18.1 mm in the conventional group (P = .038). The mean procedure time did not differ between the 2 groups. Subcutaneous emphysema as an adverse event was observed in the conventional ESD group. No treatment-related adverse events occurred in the peroral countertraction group.
Retrospective comparison.
ESD under peroral countertraction is easier and appears to be safer for completely removing superficial mesopharyngeal and hypopharyngeal cancers.
内镜黏膜下剥离术（ESD）可用于整块切除早期胃肠道肿瘤。咽部 ESD 侵袭性更小，但技术难度更大。因此，需要创新方法来安全、轻松地进行该操作。
本研究旨在评估经口对牵技术下的 ESD，该技术是一种新的牵引系统，用于改善黏膜下切割线的可视化效果，与传统 ESD 相比。
回顾性研究。
日本东京 Toranomon 医院。
共纳入 93 例（140 处病灶）接受 ESD 治疗的浅层咽部癌症患者。
经口对牵 ESD 或传统 ESD。
整块切除率、肿瘤大小和手术时间。
所有病变均采用该技术整块切除。经口对牵组最长病变的平均大小为 23.4mm，传统组为 18.1mm（P =.038）。两组的平均手术时间无差异。传统 ESD 组出现皮下气肿作为不良事件。经口对牵组未发生与治疗相关的不良事件。
回顾性比较。
经口对牵 ESD 更简单，似乎更安全，可完全切除浅层咽和下咽癌症。
