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Endoscopic submucosal dissection of appendiceal lesions by using a novel adjustable traction device: A-TRACT-2

ABSTRACT: Video Video 1 Dissections of appendiceal lesions using A-TRACT-2.

SUBMITTER: Masgnaux L

PROVIDER: S-EPMC9938289 | biostudies-literature | 2022 Nov

REPOSITORIES: biostudies-literature

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Project description:BackgroundColorectal endoscopic submucosal dissection is technically demanding, and the traction offered by gravity, cap, or clip-with-line during conventional endoscopic submucosal dissection remains unsatisfactory. Robotic systems are still under development and are expensive. We proposed double-scope endoscopic submucosal dissection with strong and adjustable traction offered by snaring the lesion with additional scope.ObjectiveThis study aimed to test the novel double-scope endoscopic submucosal dissection with snare-based traction.DesignThis was a retrospective study that reviewed double-scope endoscopic submucosal dissection compared with matched conventional endoscopic submucosal dissection, and size, location, morphology, and pathology between groups were compared.SettingsThis study was conducted in a referral endoscopy center in a local hospital.PatientsThis study included patients with colorectal lesions receiving double-scope endoscopic submucosal dissection and matched conventional endoscopic submucosal dissection.Main outcome measuresThe pathological completeness, procedure time, and complications were analyzed.ResultsFifteen double-scope endoscopic submucosal dissection procedures, with 11 lesions located in the proximal colon with a median size of 40 mm, were performed. The median procedure time of double-scope endoscopic submucosal dissection was 32.45 (interquartile range, 16.03-38.20) minutes. The time required for second scope insertion was 2.57 (interquartile range, 0.95-6.75) minutes; for snaring, 3.03 (interquartile range, 2.12-6.62) minutes; and for actual endoscopic submucosal dissection, 28.23 (interquartile range, 7.90-37.00) minutes. All lesions were resected completely. No major complication was encountered. The procedure time was significantly shorter than that of 14 matched conventional endoscopic submucosal dissections (54.61 [interquartile range, 33.11-97.25] min; p = 0.021).LimitationsThis was a single-center, single-operator, retrospective case-controlled study with limited cases.ConclusionsThis study confirmed the feasibility of double-scope endoscopic submucosal dissection with snare-based traction to shorten procedure time and to simplify endoscopic submucosal dissection. Additional trials are required.

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Endoscopic submucosal dissection of appendiceal lesions by using a novel adjustable traction device: A-TRACT-2

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