Department of Medicine, Division of Gastroenterology and Hepatology, University of Rochester Medical Center, Rochester, New York, USA.
Department of Medicine, Division of Gastroenterology, Geisinger Health System, Danville, Pennsylvania, USA.
Gastrointest Endosc. 2021 Mar;93(3):640-646. doi: 10.1016/j.gie.2020.06.068. Epub 2020 Jul 2.
The EndoRotor, nonthermal, powered endoscopic debridement (PED) instrument (Interscope Inc, Whitinsville, Mass, USA), is a novel device used in the GI tract. It uses adjustable suction and a rotary cutting blade to precisely resect mucosal and submucosal tissue. Our aim was to assess the technical feasibility, safety, and efficacy of PED using the EndoRotor device.
This was an Institutional Review Board-approved, multicenter, retrospective review. Patients underwent PED with the EndoRotor device from August 2018 to September 2019 at 4 high-volume U.S. centers. Patient demographics, indication for PED, and procedural and histopathologic data were recorded.
Thirty-four patients underwent PED (41 lesions). The most common indications for PED were colon polyps (18, 52.9%) and Barrett's esophagus (8, 23.5%). Most lesions (35, 85.4%) were resected previously for the same indication using standard techniques. Technical success was achieved in 97.6% of lesions (n = 40). Clinical success was achieved in most patients who underwent a follow-up examination (19, 79.2%). Intraprocedural bleeding (in 10 patients) was managed endoscopically; no EndoRotor-related perforations occurred. Three postprocedural adverse events occurred: self-limited chest pain in 1 patient and delayed bleeding in 2.
The EndoRotor is a novel, effective, and safe PED device for endoscopic resection of flat and polypoid lesions in the colon and foregut. It may have a promising role in the endoscopic management of naïve and scarred mucosal lesions based on this initial experience. Further prospective studies are needed to clarify its role in endoluminal resection.
EndoRotor 是一种非热、动力式内镜清创（PED）器械（美国马萨诸塞州惠廷斯维尔的 Interscope Inc. 公司），用于胃肠道。它使用可调节的吸力和旋转切割刀片精确切除黏膜和黏膜下层组织。我们的目的是评估使用 EndoRotor 装置进行 PED 的技术可行性、安全性和疗效。
这是一项机构审查委员会批准的多中心回顾性研究。2018 年 8 月至 2019 年 9 月，4 家美国高容量中心的患者接受了 EndoRotor 装置的 PED。记录患者的人口统计学、PED 适应证以及手术和组织病理学数据。
34 例患者接受了 PED（41 个病变）。PED 的最常见适应证是结肠息肉（18 例，52.9%）和 Barrett 食管（8 例，23.5%）。大多数病变（35 例，85.4%）以前因相同适应证使用标准技术切除。97.6%的病变（n=40）获得了技术成功。大多数接受随访检查的患者（19 例，79.2%）获得了临床成功。10 例患者发生术中出血，内镜下处理；无 EndoRotor 相关穿孔。3 例术后发生不良事件：1 例患者出现自限性胸痛，2 例患者出现迟发性出血。
EndoRotor 是一种新型有效的 PED 装置，可用于内镜切除结肠和前消化道的扁平息肉样病变。根据这一初步经验，它在内镜管理初治和瘢痕性黏膜病变方面可能具有广阔的应用前景。需要进一步的前瞻性研究来阐明其在腔内切除中的作用。
