Kikuchi Daisuke, Tanaka Masami, Nakamura Satoshi, Nomura Kosuke, Hayasaka Junnosuke, Ochiai Yorinari, Odagiri Hiroyuki, Yamashita Satoshi, Matsui Akira, Hoteya Shu
Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
Endosc Int Open. 2021 Apr;9(4):E606-E609. doi: 10.1055/a-1352-3805. Epub 2021 Apr 13.
Endoscopic submucosal dissection (ESD) is widely performed for superficial esophageal cancer, but stricture after extensive resection is a major clinical problem. Using an ultrathin endoscope would enable endoscopists to approach lesions beyond the stricture. We evaluated the feasibility of an ultrathin endoscope for esophageal ESD. To perform ESD with an ultrathin endoscope, we developed a transparent hood and ESD knife. A total of 24 esophageal ESDs were performed by two endoscopists with excised and live porcine esophaguses. A GIF-Q260 J and Dual knife were used in the conventional group and the GIF-XP260NS and a newly developed knife were used in the ultrathin group. En bloc resection rates, perforation rates, and procedure times were compared. All 24 lesions were resected en bloc without perforation. The mean procedure time was longer in the ultrathin group, although not significantly so (274.3 ± 81.8 s vs 435.8 ± 313.9 s, respectively; = 0.22). Although the procedure time was longer in the ultrathin group, en bloc resection was performed without any perforation. The findings indicate that esophageal ESD with an ultrathin endoscope is feasible.
内镜黏膜下剥离术（ESD）广泛应用于浅表性食管癌的治疗，但广泛切除术后的狭窄是一个主要的临床问题。使用超薄内镜可使内镜医师接近狭窄部位以外的病变。我们评估了超薄内镜用于食管ESD的可行性。为了使用超薄内镜进行ESD，我们研发了一种透明帽和ESD刀。两名内镜医师使用切除的猪食管和活猪食管共进行了24例食管ESD。传统组使用GIF-Q260 J和双极电刀，超薄组使用GIF-XP260NS和新研发的刀。比较整块切除率、穿孔率和手术时间。所有24个病变均整块切除且无穿孔。超薄组的平均手术时间较长，尽管差异无统计学意义（分别为274.3 ± 81.8秒和435.8 ± 313.9秒；P = 0.22）。尽管超薄组的手术时间较长，但整块切除未发生任何穿孔。这些结果表明，使用超薄内镜进行食管ESD是可行的。
