Department of Endoscopy, The Jikei University School of Medicine, 3-25-8 Nishi Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
BMC Gastroenterol. 2022 Jan 6;22(1):10. doi: 10.1186/s12876-021-02085-w.
Endoscopic submucosal dissection (ESD) is technically difficult and requires considerable training. The authors have developed a multi-loop traction device (MLTD), a new traction device that offers easy attachment and detachment. We aimed to evaluate the utility of MLTD in ESD.
This ex vivo pilot study was a prospective, block-randomized, comparative study of a porcine stomach model. Twenty-four lesions were assigned to a group that undertook ESD using the MLTD (M-ESD group) and a group that undertook conventional ESD (C-ESD group) to compare the speed of submucosal dissection. In addition, the data of consecutive 10 patients with eleven gastric lesions was collected using electronic medical records to clarify the inaugural clinical outcomes of gastric ESD using MLTD.
The median (interquartile range) speed of submucosal dissection in the M-ESD and C-ESD groups were 141.5 (60.9-177.6) mm2/min and 35.5 (20.8-52.3) mm2/min, respectively; submucosal dissection was significantly faster in the M-ESD group (p < 0.05). The rate of en bloc resection and R0 resection was 100% in both groups, and there were no perforation in either group. The MLTD attachment time was 2.5 ± 0.9 min and the MLTD extraction time was 1.0 ± 1.1 min. Clinical outcomes of MLTD in gastric ESD were almost the same as those of ex vivo pilot study.
MLTD increased the speed of submucosal dissection in ESD and was similarly effective when used by expert and trainee endoscopists without perforation. MLTD can potentially ensure a safer and faster ESD.
内镜黏膜下剥离术（ESD）技术难度大，需要大量培训。作者开发了一种多环牵引装置（MLTD），这是一种新的牵引装置，易于附着和拆卸。我们旨在评估 MLTD 在 ESD 中的应用。
这是一项使用猪胃模型的前瞻性、块随机、对照的离体研究。24 个病变被分配到接受 MLTD 行 ESD 的组（M-ESD 组）和接受传统 ESD 的组（C-ESD 组），以比较黏膜下剥离的速度。此外，还通过电子病历收集了 10 例连续患者的 11 个胃病变数据，以明确 MLTD 用于胃 ESD 的初始临床结果。
M-ESD 组和 C-ESD 组黏膜下剥离的中位（四分位距）速度分别为 141.5（60.9-177.6）mm2/min 和 35.5（20.8-52.3）mm2/min；M-ESD 组的黏膜下剥离速度明显更快（p<0.05）。两组的整块切除率和 R0 切除率均为 100%，均无穿孔。MLTD 附着时间为 2.5±0.9 min，MLTD 提取时间为 1.0±1.1 min。胃 ESD 中 MLTD 的临床结果与离体研究几乎相同。
MLTD 增加了 ESD 中的黏膜下剥离速度，并且在熟练和受训内镜医师使用时同样有效，没有穿孔。MLTD 可以确保更安全、更快的 ESD。
Zotero 插件