Kagawa University, Faculty of Medicine, Department of Gastroenterology and Neurology, Kagawa, Japan. .
Kagawa University, Faculty of Medicine, Department of Gastroenterology and Neurology, Kagawa, Japan.
J Gastrointestin Liver Dis. 2022 Dec 16;31(4):390-395. doi: 10.15403/jgld-4524.
The most suitable procedure for resecting small-sized gastric neoplasms remains unclear. Endoscopic mucosal resection leads to non-curative resection owing to slippage of the snare, and technically difficult endoscopic submucosal dissection (ESD) is instrumentally uneconomical. A novel, cost-effective, multifunctional snare called SOUTEN is available as a hybrid ESD (h-ESD) device developed for facilitating ESD. This study aimed to assess the acceptability of h-ESD using the SOUTEN for resecting small-sized gastric neoplasms.
This was a prospective observational study conducted at our single institution between March 2019 and March 2021. Fifty-seven consecutive patients who underwent h-ESD using SOUTEN for small-sized gastric neoplasms ≤15 mm involving adenoma and tubular-type mucosal carcinoma without ulceration were enrolled. The primary outcome was curative resection rate for h-ESD. Secondary outcomes were the rates of conversion to ESD, rate of total (h-ESD + ESD) curative resection, procedure time, rates of intra-and post- operative complications, and presence of additional knives excluding hemostatic forceps.
The curative resection rate of h-ESD was 89.5% (51/57). The total (h-ESD + ESD) curative resection rate was 94.7% (54/57). The mean procedure time was 21.2 (±16.5) minutes. One case of delayed bleeding occurred. Additional knives were applied in two cases.
The cost-efficient h-ESD using SOUTEN can be an acceptable procedure for resecting small- sized gastric neoplasms.
切除小尺寸胃肿瘤最适宜的方法仍不明确。由于圈套器滑脱，内镜下黏膜切除术导致非治愈性切除，且技术上困难的内镜黏膜下剥离术（ESD）在器械方面不经济。一种新型、具有成本效益的多功能圈套器，即 SOUTEN，可用作开发用于促进 ESD 的混合 ESD（h-ESD）器械。本研究旨在评估使用 SOUTEN 行 h-ESD 切除小尺寸胃肿瘤的可接受性。
这是一项在我院进行的前瞻性观察性研究，时间为 2019 年 3 月至 2021 年 3 月。共纳入 57 例连续接受 h-ESD 治疗的患者，其使用 SOUTEN 切除≤15mm 的小尺寸胃肿瘤，涉及无溃疡的腺瘤和管状型黏膜癌。主要结局是 h-ESD 的治愈性切除率。次要结局包括转为 ESD 的比率、总（h-ESD+ESD）治愈性切除率、手术时间、术中及术后并发症发生率，以及除外止血夹的额外刀数。
h-ESD 的治愈性切除率为 89.5%（51/57）。总（h-ESD+ESD）治愈性切除率为 94.7%（54/57）。平均手术时间为 21.2（±16.5）分钟。1 例发生延迟性出血。2 例使用了额外的刀。
使用 SOUTEN 的具有成本效益的 h-ESD 可以成为切除小尺寸胃肿瘤的可接受方法。
