A multicenter, retrospective study of a through-the-needle injection–Capable electrosurgical knife for endoscopic submucosal dissection Journal Article
| Authors: | Aihara, H.; Othman, M. O.; Jawaid, S. A.; Gorgun, E.; Sharma, N. R.; Siddiqui, U. D.; Peetermans, J. A.; Rousseau, M. J.; Nishimura, M. |
| Article Title: | A multicenter, retrospective study of a through-the-needle injection–Capable electrosurgical knife for endoscopic submucosal dissection |
| Abstract: | Background and Aims: Endoscopic submucosal dissection (ESD) is a technically challenging resection technique for en bloc removal of dysplastic and early cancerous GI lesions. We conducted a single-arm retrospective study evaluating the safety and efficacy of a new through-the-needle injection–capable electrosurgical knife used in upper and lower ESD procedures performed at 6 U.S. academic centers. Methods: Data were retrospectively collected on consecutive cases in which the new ESD knife was used. The primary efficacy endpoint was successful ESD (en bloc resection with negative margins). Secondary efficacy endpoints included en bloc resection rate, curative resection rate, median ESD time, and median dissection speed. The safety endpoint was device- or procedure-related serious adverse events. Results: ESD procedures of 581 lesions in 579 patients were reviewed, including 187 (32.2%) upper GI and 394 (67.8%) lower GI lesions. Prior treatment was reported in 283 (48.9%) patients. Successful ESD was achieved in 477 (82.1% of 581) lesions—lower for patients with versus without submucosal fibrosis (73.6% vs 87.0%, respectively; P < .001) but similar for those with versus without previous treatment (81.7% vs 82.3%, respectively; P = .848). A total of 443 (76.2% of 581) lesions met criteria for curative resection. Median ESD time was 1.0 (range, 0.1-4.5) hour. Median dissection speed was 17.1 (interquartile range, 5.3-29.8) cm2/h. Related serious adverse events were reported in 15 (2.6%) patients, including delayed hemorrhage (1.9%), perforation (0.5%), or postpolypectomy syndrome (0.2%). Conclusion: A newly developed through-the-needle injection–capable ESD knife showed a good success rate and excellent safety at U.S. centers. (Clinical trial registration number: NCT04580940.) © 2024 American Society for Gastrointestinal Endoscopy |
| Keywords: | adult; controlled study; treatment outcome; aged; aged, 80 and over; middle aged; antibiotic agent; antibiotic therapy; cancer surgery; retrospective studies; major clinical study; clinical trial; antineoplastic agent; medical record review; retrospective study; postoperative complication; gastrointestinal neoplasms; heart infarction; multicenter study; operation duration; surgery; hospital discharge; colon perforation; clinical effectiveness; heart arrhythmia; postoperative hemorrhage; radiofrequency ablation; hemicolectomy; electrosurgery; duodenum; stomach neoplasms; chemoradiotherapy; stomach tumor; cecum; en bloc resection; surgical margin; gastrointestinal tumor; stomach fundus; tumor ablation; narrow band imaging; endoscopic mucosal resection; devices; gastroesophageal junction; procedures; cardia; endoscopic submucosal dissection; cecum disease; gastric mucosa; sigmoid; stomach antrum; stomach mucosa; digestive system injury; operative time; device safety; ascending colon; transverse colon; very elderly; emergency surgery; humans; human; male; female; article; endoscopist; descending colon; anonymised data; gastrointestinal adenocarcinoma; stomach corpus; gastrointestinal dysplasia; argon plasma ablation; ileocecal valve; postpolypectomy syndrome |
| Journal Title: | Gastrointestinal Endoscopy |
| Volume: | 100 |
| Issue: | 6 |
| ISSN: | 0016-5107 |
| Publisher: | Mosby Elsevier |
| Date Published: | 2024-12-01 |
| Start Page: | 1034 |
| End Page: | 1042 |
| Language: | English |
| DOI: | 10.1016/j.gie.2024.06.011 |
| PUBMED: | 38879045 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
