具有水喷射功能的双极电切刀（Jet B-knife）可缩短结直肠肿瘤内镜黏膜下剥离术的手术时间。

Bipolar-current needle-knife with a water jet function (Jet B-knife) shortens the procedure time of endoscopic submucosal dissection for colorectal tumors.

机构信息

Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.

Toyama Prefectural Central Hospital, Toyama, Japan.

出版信息

Surg Endosc. 2021 Jul;35(7):3600-3606. doi: 10.1007/s00464-020-07832-w. Epub 2020 Jul 28.

DOI:10.1007/s00464-020-07832-w

PMID:32725477

Abstract

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.

摘要

背景

内镜黏膜下剥离术（ESD）是一种治疗大肠肿瘤的技术难度大、耗时的手术。在日本，球头双极电刀（BB 刀）已应用于 ESD 中，是一种安全的器械，可以最大限度地减少大肠肿瘤深部组织的损伤。2012 年 5 月，新开发了一种带有水喷射功能的 BB 刀（Jet B 刀）。

方法

本回顾性研究旨在检查 Jet B 刀的有效性和安全性。BB 刀用于 276 个病变（BB 刀组），Jet B 刀用于 245 个病变（Jet B 刀组）。我们评估了肿瘤特征和 ESD 手术结果，包括切除肿瘤的大小、组织学诊断、切除所需时间、其他电刀使用频率、整块切除率和相关并发症发生率。然后，比较两组之间的数据。

结果

切除肿瘤的组织学评估显示，两组癌症发生率无显著差异。BB 刀组切除时间中位数为 103 分钟（45-255），Jet B 刀组为 51 分钟（28-210）。差异有统计学意义（p<0.05）。此外，BB 刀和 Jet B 刀组的中位肿瘤直径分别为 23.1 毫米（18-50）和 26.2 毫米（20-60），差异有统计学意义（p<0.05）。多变量逻辑回归分析显示，短切除时间（p<0.001）和减少使用止血器械（p<0.01）是 Jet B 刀的独立有利特征。两组的整块切除率和穿孔率无统计学差异。