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Usefulness of dexmedetomidine for endoscopic submucosal dissection in colon

ABSTRACT: Interventions: dexmedetomidine placebo Primary outcome(s): Satisfaction in patient Study Design: Parallel Randomized

DISEASE(S): Colorectal Tumor

PROVIDER: 2637033 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Dexmedetomidine for sedation during endoscopic submucosal dissection of early gastrointestinal lesion

Project description:Interventions: Endoscopic submucosal dissection is performed using sedation of dexmedetomidine. Primary outcome(s): Two hours after the treatmentwas finished, patient’s quaestionaire about pain, nausea and satisfaction of the sedation is evaluated. Study Design: Single arm Non-randomized

| 2635391 | ecrin-mdr-crc

Usefulness of a multibending endoscope in gastric endoscopic submucosal dissection.

Project description:Background and aimsIntraoperative perforation is a major adverse event of endoscopic submucosal dissection (ESD). To avoid perforation, it is important for the endoscope to approach the portion to be resected carefully and to ensure that the knife can approach the submucosa at an angle parallel to the muscle layer. The multibending endoscope has 2 bends at its tip and may facilitate the ESD procedure. To the best of our knowledge, very few studies have reported the use of the multibending endoscope during gastric ESD. The aim of this study was, therefore, to introduce the usefulness of the multibending endoscope for gastric ESD.MethodsWe report 2 cases of early gastric cancer in which ESD was performed using a multibending endoscope.ResultsUnlike conventional single-bending endoscopes that have only 1 moveable part, the multibending endoscope allowed difficult areas to be approached more easily. Small adjustments could be made to the upward or downward angle of both the first and the second bending sections of the endoscope. This ensured that the knife would approach the submucosa at an angle parallel to the muscle layer. In patient 1, initially the conventional endoscope was used, but it became more difficult to approach the site, and paradoxic movement occurred. When the conventional endoscope was changed to the multibending endoscope, the ESD procedure became safer and more efficient. Another ESD using the multibending endoscope was performed successfully without any adverse events.ConclusionsThe use of a multibending endoscope for ESD will enable safer and faster treatment of patients.

| S-EPMC6895728 | biostudies-literature

Hand-suturing-assisted traction technique and closure in colon endoscopic submucosal dissection.

Project description: Not available

| S-EPMC11910326 | biostudies-literature

Usefulness of step-by-step double-clip-with-line method in duodenal endoscopic submucosal dissection.

Project description: Not available

| S-EPMC8276354 | biostudies-literature

Countertraction in endoscopic submucosal dissection.

Project description: Not available

| S-EPMC5989134 | biostudies-literature

Dexmedetomidine for conscious sedation with colorectal endoscopic submucosal dissection: a prospective double-blind randomized controlled study.

Project description:ObjectiveConscious sedation for colorectal endoscopic submucosal dissection (ESD) has not been standardized, and there are no studies of sedation for colorectal ESD.MethodsWe conducted a prospective double-blind randomized controlled trial to clarify the usefulness of DEX during colorectal ESD. In total 80 patients with colorectal ESD from April 2016 to May 2017 were assigned to the placebo group or the DEX group (40 cases each). The primary outcome was patient satisfaction (visual analogue scale: VAS). Secondary outcomes were evaluated for 13 factors, including patient pain level (VAS), endoscopist satisfaction (VAS), objective patient pain level viewed from the endoscopist's perspective (VAS), rate of patient response, rate of side effects, etc., from the patient's and endoscopist's perspectives.ResultsPatient satisfaction was 8.4 and 9.1 (P = 0.018) in the placebo group and the DEX group, respectively. Secondary outcomes of patient pain level, endoscopist satisfaction, objective patient pain level from the endoscopist's perspective for the placebo and DEX groups were 1.2 and 0.4 (P = 0.045), 8.2 and 9.3 (P < 0.001), and 1.2 and 0.5 (P = 0.002), respectively. All of these were significantly positive results (more comfortable and less pain) in the DEX group. The rate of a patient response was 100% in all cases. The side effects (hypoxia/bradycardia/hypotension) were 0%/0%/0% and 7.5%/7.5%/5% (P = 0.030). However, these rates were less than the reported side effect occurrence rate, and no additional medication was needed.ConclusionDEX enables conscious sedation, and is useful not only for patient and endoscopist satisfaction but also for pain relief. DEX is an effective sedation method for colorectal ESD.

| S-EPMC6030068 | biostudies-literature

Underwater endoscopic submucosal dissection and hybrid endoscopic submucosal dissection as rescue therapy in difficult colorectal cases.

Project description:Background and study aims Colorectal endoscopic submucosal dissection (ESD) is still not widely used due to its technical difficulty and the risk of complications. Rescue therapies such as hybrid ESD (H-ESD) have been proposed for very difficult cases, as has underwater ESD (U-ESD). This study evaluated the safety and efficacy of H-ESD and U-ESD in difficult cases. Patients and methods The hospital charts of consecutive patients referred for colorectal ESD between January 2014 and February 2021 because they were considered difficult cases were retrospectively analyzed. The primary outcome of the study was en bloc resection rate; secondary outcomes were the rate of complete resection, procedure speed, and incidence of adverse events (AEs). Results Fifty-nine colorectal neoplasms were considered, 22 of which were removed by U-ESD and 37 by H-ESD. The en bloc resection rate in the U-ESD group was 100 %, while it was 59.5 % in the H-ESD group. Dissection speed was 17.7mm 2 /min in the U-ESD group and 8.3 mm 2 /min in the H-ESD group. The AE rate was low in the U-ESD group and moderately high during H-ESD (5 % and 21.6 %, respectively; and perforation rate 0 % and 10.8 %, respectively). Larger lesions were treated with U-ESD, while more fibrotic ones were treated with H-ESD. Conclusions U-ESD and H-ESD are both effective and safe techniques in difficult colorectal situations. U-ESD is particularly effective and fast for large lesions when it is not possible to obtain comfortable knife position, while H-ESD is more suitable for very fibrotic lesions.

| S-EPMC9473857 | biostudies-literature

Maximizing limited space: usefulness of percutaneous cricothyrotomy and super-soft hood for hypopharyngeal endoscopic submucosal dissection.

Project description:Video 1Demonstration of the usefulness of percutaneous cricothyrotomy and a super-soft hood for hypopharyngeal endoscopic submucosal dissection.

| S-EPMC10577375 | biostudies-literature

Usefulness of the right lateral decubitus push method in endoscopic submucosal dissection for upper gastric lesions.

Project description: Not available

| S-EPMC11884971 | biostudies-literature

Usefulness of the S-O clip for duodenal endoscopic submucosal dissection: a propensity score-matched study.

Project description:Background/aimsEndoscopic submucosal dissection (ESD) for superficial non-ampullary duodenal tumors (SNADETs) is associated with a high rate of en bloc resection. However, the technique for ESD remains challenging. Recent studies have demonstrated the effectiveness of S-O clips in colonic and gastric ESD. We evaluated the efficacy and safety of duodenal ESD using an S-O clip for SNADETs.MethodsConsecutive patients who underwent ESD for SNADETs between January 2011 and December 2021 were retrospectively enrolled. Propensity score matching analysis was used to compare patients who underwent duodenal ESD with the S-O clip (S-O group) and those who underwent conventional ESD (control group). Intraoperative perforation rate was the primary outcome, while procedure time and R0 resection rate were the secondary outcomes.ResultsAfter propensity score matching, 16 pairs were created: 43 and 17 in the S-O and control groups, respectively. The intraoperative perforation rate in the S-O group was significantly lower than that in the control group (p=0.033). A significant difference was observed in the procedure time between the S-O and control groups (39±9 vs. 82±30 minutes, respectively; p=0.003).ConclusionThe S-O clip reduced the intraoperative perforation rate and procedure time, which may be useful and effective in duodenal ESD.

| S-EPMC10665626 | biostudies-literature

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