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Clutch Cutter knife efficacy in endoscopic submucosal dissection for early gastric neoplasms

World Journal of Gastrointestinal Oncology 2018年第12期10卷 487-495页

作者： Yasuyo Hayashi Mitsuru Esaki Sho Suzuki Eikichi Ihara Azusa Yokoyama Seiichiro Sakisaka taizo hosokawa Yoshimasa Tanaka Takahiro Mizutani Shinichi Tsuruta Aya Iwao Shun Yamakawa Akira Irie Yosuke Minoda Yoshitaka Hata Haruei Ogino Hirotada Akiho Yoshihiro Ogawa Department of Medicine and Bioregulatory Science Graduate School of Medical SciencesKyushu University Department of Gastroenterology Kitakyushu Municipal Medical Center Division of Gastroenterology and Hepatology Department of MedicineNihon University School of Medicine Department of Anatomic Pathology Graduate School of Medical Sciences Kyushu University

AIM To compare the outcomes of endoscopic submucosal dissection(ESD) for gastric neoplasms using Clutch Cutter(ESD-C) or other knives(ESD-O).METHODS This was a single-center retrospective study. Gastric neoplasms treated by ESD between April 2016 and October 2017 at Kitakyushu Municipal Medical Center were reviewed. Multivariate analyses and propensity score matching were used to reduce biases. Covariates included factors that might affect outcomes of ESD, including age, sex, underlying disease, anti-thrombotic drugs use, tumor location, tumor position, tumor size, tumor depth, tumor morphology, tumor histology, ulcer(scar), and operator skill. The treatment outcomes were compared among two groups. The primary outcome was ESD procedure time. Secondary outcomes were en bloc, complete, and curative resection rates, and adverse events rates including perforation and delayed *** A total of 155 patients were included in this study; 44 pairs were created by propensity score matching. Background characteristics were quite similar among two groups after matching. Procedure time was significantly shorter for ESD-C(median; 49 min) than for ESD-O(median; 88.5 min)(P < 0.01). However, there was no significant difference in treatment outcomes between ESD-C and ESD-O including en bloc resection rate(100% in both groups), complete resection rate(100% in both groups), curative resection rate(86.4% vs 88.6%, P = 0.730), delayed bleeding(2.3% vs 6.8%, P = 0.62) and perforation(0% in both groups).CONCLUSION ESD-C achieved shorter procedure time without an increase in complication risk. Therefore, ESD-C could become an effective ESD option for gastric neoplasms.

关键词： Endoscopic submucosal dissection Clutch Cutter Gastric neoplasm Knife Propensity score

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