Efficacy of an endo-knife with a water-jet function (Flushknife) for endoscopic submucosal dissection of superficial colorectal neoplasms
| Autor: | Rika Chatani, Yoji Takeuchi, Koji Higashino, Hiroyasu Iishi, Noriya Uedo, Toshio Shimokawa, Natsuko Kawada, Takuya Inoue, Takashi Kizu, Noboru Hanaoka, Ryu Ishihara, Masaharu Tatsuta, Tomoyasu Taniguchi |
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| Rok vydání: | 2009 |
| Předmět: |
Adenoma
Adult Male medicine.medical_specialty Colorectal cancer education Electrosurgery Colonoscopy complex mixtures medicine Humans Prospective Studies Intestinal Mucosa Colonic disease Aged Aged 80 and over Hepatology medicine.diagnostic_test Colonoscopes business.industry Dissection Carcinoma Gastroenterology Water jet Cancer Water Endoscopic submucosal dissection Equipment Design Middle Aged equipment and supplies medicine.disease Endoscopy Surgery surgical procedures operative Treatment Outcome Female sense organs business Colorectal Neoplasms Rectal disease |
| Zdroj: | The American journal of gastroenterology. 105(2) |
| ISSN: | 1572-0241 |
| Popis: | Endoscopic submucosal dissection (ESD) is currently not a common treatment for colorectal neoplasms because it is time consuming and technically difficult. Flushknife--an electrosurgical endo-knife with a water-jet function--is expected to reduce the difficulty of colorectal ESD. The objective of this study was to investigate the efficacy of a water-jet function for colorectal ESD.This study was a prospective randomized controlled trial, which was conducted at a cancer referral center. A total of 49 patients, with a total of 51 superficial colorectal neoplasms (median tumor size of 30 mm), were enrolled and randomly assigned to undergo ESD using either the Flexknife (electrosurgical endo-knife without a water-jet function) or the Flushknife. Tumors were resected by ESD using each endo-knife. The procedures were conducted by two endoscopists. Operation time was defined as the main outcome measure.En bloc resection was achieved in 23 out of 26 (88%) lesions in the Flexknife group and in 24 out of 24 (100%) lesions in the Flushknife group. The mean operation time (95% confidence interval) was 87.3 (71.3-103.4) min in the Flexknife group and 61.0 (49.3-72.7) min in the Flushknife group (P=0.02). The Flushknife reduced the number of endoscopic device changes (P=0.001), the number of submucosal injections (P=0.001), and the mean amount of injected hyaluronate sodium (P=0.001) compared with the Flexknife. No severe adverse events were observed in either group.Without increasing adverse events, the endo-knife with a water-jet function efficiently reduced the operation time of colorectal ESD in patients with large superficial colorectal neoplasms. (University hospital Medical Information Network Clinical Trials Registry number UMIN000001302). |
| Databáze: | OpenAIRE |
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