Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.
Center for Translational Research, The Institute of Medical Science Hospital, The University of Tokyo, Tokyo, Japan.
Gastrointest Endosc. 2020 Jan;91(1):185-190. doi: 10.1016/j.gie.2019.08.042. Epub 2019 Sep 12.
Traction methods have been reported to speed up endoscopic submucosal dissection (ESD). We used the multiloop (M-loop) method as a traction method for colorectal ESD and recorded the submucosal dissection time (SDT) and submucosal dissection speed (SDS).
From January to August 2018, we used the M-loop method for colorectal ESD procedures and timed the duration and recorded the outcomes. Two experts and eight nonexperts performed the procedures, which were carried out at a tertiary endoscopic center in Japan.
A total of 50 patients were treated by colorectal ESD using the M-loop method. The mean SDT was 42.1 ± 4.16 minutes and the mean SDS was 28.0 ± 2.89 mm/minutes. The mean SDS was 38.9 ± 6.9 mm/minutes for experts and 25.3 ± 3.1 mm/minutes for nonexperts. En bloc resection was achieved in 100% of cases. There were 3 adverse events and unfavorable outcomes.
Traction by the M-loop method improved SDS in colorectal ESD. The method can be an effective tool to assist colorectal ESD. Further evaluation of the usefulness of the M-loop method is required in direct comparison with conventional ESD.
已有报道称牵引方法可加速内镜黏膜下剥离术（ESD）。我们使用多环（M 环）方法作为结直肠 ESD 的牵引方法，并记录黏膜下剥离时间（SDT）和黏膜下剥离速度（SDS）。
2018 年 1 月至 8 月，我们在日本的一家三级内镜中心使用 M 环法进行结直肠 ESD 手术，并计时和记录结果。两位专家和八位非专家进行了这些手术。
共 50 例患者接受 M 环法结直肠 ESD 治疗。平均 SDT 为 42.1 ± 4.16 分钟，平均 SDS 为 28.0 ± 2.89mm/min。专家的平均 SDS 为 38.9 ± 6.9mm/min，非专家为 25.3 ± 3.1mm/min。100%的病例均达到整块切除。有 3 例不良事件和不良结局。
M 环法的牵引提高了结直肠 ESD 的 SDS。该方法可以成为辅助结直肠 ESD 的有效工具。需要与传统 ESD 进行直接比较，进一步评估 M 环法的有用性。
