Clip-and-snare method with a pre-looping technique versus conventional method in the treatment of precancerous lesion and early gastric cancer: a retrospective study-Reference-Cited by-同舟云学术

Clip-and-snare method with a pre-looping technique versus conventional method in the treatment of precancerous lesion and early gastric cancer: a retrospective study

Published:2024-05-17 Issue:1 Volume:24 Page:
ISSN:1471-230X
Container-title:BMC Gastroenterology
language:en
Short-container-title:BMC Gastroenterol

Author:

Deng Ruichong,Wu Jiatong,Li Defeng,Wu Benhua,Shi Ruiyue,Tian Yanhui,Yao Jun,Wang Li-sheng

Abstract

Abstract Background Low grade intraepithelial neoplasia (LGIN) and high grade intraepithelial neoplasia (HGIN) are potential precancerous lesion of gastric neoplasms. Endoscopic submucosal dissection (ESD) is the first option for the treatment of precancerous lesion and early gastric cancer (EGC). Traction is an effective method to improve efficiency, and reduce complications during ESD. In this study, we shared a useful traction method using the clip-and-snare method with a pre-looping technique (CSM-PLT) for precancerous lesion and EGC. Methods We retrospectively analyzed patients received ESD combined with CSM-PLT or conventional ESD from June 2018 to December 2021 in Shenzhen People’s hospital. The primary outcome was resection speed. Results Forty-two patients were enrolled in ESD combined with CSM-PLT group and sixty-five patients in conventional ESD group respectively. Baseline characteristics were comparable among two groups (P>0.05). There were no significant differences in terms of R0 resection rate, en bloc resection rate (97.6% vs. 98.5%, P = 1.000 and 97.6% vs. 96.9%, P = 1.000, respectively), operation costs (933.7 (644.1-1102.4) dollars vs. 814.7 (614.6-988.3) dollars, P = 0.107), and hospital stays (8.0 ± 3.1 days vs. 7.3 ± 3.2 days, P = 0.236). In addition, no significant difference was observed with respect to complications (P>0.05). However, the resection speed of ESD combined with CSM-PLT was faster than that of conventional ESD (11.3 (9.4–14.9) mm2/min vs. 8.0 (5.8–10.9) mm2/min, P < 0.001), particularly lesions located in anterior wall and lesser curvature. In addition, the association between ESD combined with CSM-PLT and resection speed was still supported after propensity matching scores (PMS). Conclusions CSM-PLT can help to improve ESD efficiency without reducing the en bloc resection rate or increasing the incidence of complications.

Publisher

Springer Science and Business Media LLC

Link

https://link.springer.com/content/pdf/10.1186/s12876-024-03231-w.pdf

Reference30 articles.

1. Pimentel-Nunes P, Dinis-Ribeiro M, Ponchon T, Repici A, Vieth M, De Ceglie A, et al. Endoscopic submucosal dissection: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2015;47(9):829–54.

2. Suzuki S, Gotoda T, Kobayashi Y, Kono S, Iwatsuka K, Yagi-Kuwata N, et al. Usefulness of a traction method using dental floss and a hemoclip for gastric endoscopic submucosal dissection: a propensity score matching analysis (with videos). Gastrointest Endosc. 2016;83(2):337–46.

3. Nagata M. Internal traction method using a spring–and–loop with clip (S–O clip) allows countertraction in gastric endoscopic submucosal dissection. Surg Endosc. 2020;34(8):3722–33.

4. Xie X, Bai JY, Fan CQ, Yang X, Zhao XY, Dong H, et al. Application of clip traction in endoscopic submucosal dissection to the treatment of early esophageal carcinoma and precancerous lesions. Surg Endosc. 2017;31(1):462–8.

5. Shichijo S, Takeuchi Y, Matsuno K, Uedo N, Kono M, Fukuda H, et al. Pulley traction-assisted colonic endoscopic submucosal dissection: a retrospective case series. Dig Dis. 2019;37(6):473–7.