Project description:Recently, traction-assisted endoscopic submucosal dissection (ESD) using a clip and thread was reported as useful for treating lesions in the esophagus, stomach, and colorectum in terms of shortening the duration of the procedures and reducing the risk of intraoperative perforation. However, no traction method using the thread and clip for duodenal ESD as described in this article has been reported to date. We report a case in which traction-assisted ESD using dental floss and a clip was successfully performed on a huge superficial nonampullary duodenal epithelial tumor accompanied by severe fibrosis caused by preoperative biopsies. A 65-year-old woman had a 55-mm flat-elevated tumor in the second part of the duodenum. Severe fibrosis of the submucosal layer was expected due to repeated biopsies at the same site by the patient's previous endoscopist. We selected ESD for this lesion, and the initial incision was started from the side proximal to the lesion, but it was difficult to insert the scope under the submucosal layer directly beneath the biopsy scar. Therefore, traction with an endoclip and dental floss was performed to lift the lesion. Excellent traction allowed safe resection of the fibrotic part under accurate visual observation. Finally, the lesion was resected en bloc without adverse events. Traction-assisted ESD using dental floss and a clip is likely to be an effective adjunctive technique for quick, safe, and successful resection of lesions in the duodenum on which it is difficult to perform ordinary ESD and that have a high probability of intraoperative perforation and massive bleeding.

| S-EPMC6487824 | biostudies-literature

Traction-assisted colonic endoscopic submucosal dissection using clip and line: a feasibility study.

Project description:Colonic endoscopic submucosal dissection (ESD) is a challenging procedure because it is often difficult to maintain good visualization of the submucosal layer. To facilitate colonic ESD, we designed a novel traction method, namely traction-assisted colonic ESD using clip and line (TAC), and investigated its feasibility.We retrospectively analyzed 23 patients with large colonic superficial lesions who had undergone TAC. The main outcome was the procedural success rate of TAC, which we defined as successful, sustained application of clip and line to the lesion until the end of the procedure.The procedural success rate of TAC was 87 % (20/23). In all three unsuccessful cases, the lesions were in the proximal colon and the procedure times over 100 minutes. The overall mean procedure time was 61 min (95 % confidence interval, 18 - 172 min). We achieved en bloc resections of all lesions. There were no perforations or fatal adverse events.TAC is feasible and safe for colonic ESD and may improve the ease of performing this procedure.

| S-EPMC4713171 | biostudies-other

Endoscopic submucosal dissection by use of a modified dental floss clip method for recurrent tumor in the cecum.

Project description: Not available

| S-EPMC6004021 | biostudies-literature

A novel clip-band traction device to facilitate colorectal endoscopic submucosal dissection and defect closure.

Project description: Not available

| S-EPMC7221251 | biostudies-literature

A Clip-with-Line Traction Suture Method for Closing Mucosal Defects after Endoscopic Submucosal Dissection.

Project description:Endoscopic submucosal dissection (ESD) is a technically difficult endoscopic procedure for treating gastrointestinal diseases. Procedure time is longer, and complications such as mucosal defects, intraoperative perforation, and bleeding occur frequently. Here, to solve these problems, we described the clip-with-line traction suture method that applied and performed for closing mucosal defects after ESD in three representative cases.

| S-EPMC7946448 | biostudies-literature

Multipoint traction technique in endoscopic submucosal dissection.

Project description: Not available

| S-EPMC6098703 | biostudies-literature

Internal traction method using a spring-and-loop with clip (S-O clip) allows countertraction in gastric endoscopic submucosal dissection.

Project description:BackgroundInsufficient countertraction and poor field of vision make endoscopic submucosal dissection (ESD) difficult. Internal traction method using a spring-and-loop with clip (SLC) allows sufficient traction in any direction and good field of vision. However, the attachment procedure is difficult and interference with the endoscope can occur in the retroflexed endoscopic position. We have developed a new use of SLC that simplifies the attachment procedure, eliminating interference with the endoscope. The aim of this study was to investigate the efficacy of SLC for gastric ESD.MethodsWe retrospectively recruited 140 patients with gastric neoplasms who underwent ESD between November 2015 and October 2018 at our department. Among them, 51 patients treated using SLC-assisted ESD (SLC-ESD) and 89 patients treated using conventional ESD (C-ESD) were compared. Propensity score matching was performed to compensate for the differences in age, sex, lesion location, lesion position, specimen size, and ulcer findings. The primary outcome was ESD procedure time.ResultsPropensity score matching generated 51 matched pairs. The procedure time in the SLC-ESD group was significantly shorter than that in the C-ESD group (median [interquartile], 40.0 [27.0-81.5] minutes versus 69.0 [46.5-113.5] minutes, P = 0.008). The mean SLC attachment time was 2.08 min. There were no significant differences in complete en bloc resection rate between SLC-ESD and C-ESD groups (100% versus 96.1%, P = 0.495). There were not perforation cases in either group.ConclusionsSLC may offer an efficient method for gastric ESD, with a short attachment procedure time.

| S-EPMC7326859 | biostudies-literature

Endoscopic findings of esophageal submucosal gland duct adenoma.

Project description: Not available

| S-EPMC6669342 | biostudies-literature