Colorectal endoscopic submucosal dissection using the pocket-creation method with single clip traction: a feasibility study.

Abstract

Background and study aims  The pocket-creation method (PCM) facilitates dissection of the central part of a tumor. We previously developed the PCM with clip traction (PCM-CT) to facilitate opening the mucosal pocket, which otherwise could become cumbersome. In the present study, we aimed to examine the feasibility of PCM-CT for colorectal endoscopic submucosal dissection (ESD). Patients and methods  PCM-CT was performed on 30 patients with early colorectal tumors from October 2019 to April 2020. PCM-CT allows efficient opening of the mucosal pocket by using the PCM to dissect the center of the lesion and then apply traction with a single clip after making a circumferential mucosal incision. Results  The median specimen major axis length, ESD time, ESD speed, and en bloc resection rate were 48 mm, 84 minutes, 20 mm 2 /min, and 100 % (30/30), respectively. The success rates for the traction clip and median single-clip-traction time were 100 % (30/30) and 1.5 minutes, respectively. Conclusions  Colorectal ESD using PCM-CT is a simple and promising method.

• Authors: Tatsuma Nomura, Yoshikazu Hayashi, Takaaki Morikawa, Masahiro Okada, Hisashi Fukuda, Takahito Takezawa, Keijiro Sunada, Alan Kawarai Lefor, Hironori Yamamoto
• Journal: Endoscopy international open (Endosc Int Open) Vol. 9 Issue 5 Pg. E653-E658 (May 2021) ISSN: 2364-3722 [Print] Germany
• PMID: 33937504 (Publication Type: Journal Article)
• Copyright: The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).