PMID- 26320698
OWN - NLM
STAT- MEDLINE
DCOM- 20161020
LR  - 20161230
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 83
IP  - 2
DP  - 2016 Feb
TI  - Usefulness of a traction method using dental floss and a hemoclip for gastric
      endoscopic submucosal dissection: a propensity score matching analysis (with
      videos).
PG  - 337-46
LID - 10.1016/j.gie.2015.07.014 [doi]
LID - S0016-5107(15)02660-7 [pii]
AB  - BACKGROUND AND AIMS: Although endoscopic submucosal dissection (ESD) is a
      significant advancement in therapeutic endoscopy, it is a complicated technique
      and requires considerable expertise. In this exploratory study, we evaluated the 
      efficacy of a simple traction method that uses dental floss and a hemoclip (DFC) 
      and was developed to overcome the technical difficulties of ESD. METHODS: In
      total, 238 early gastric cancers treated by ESD between May 2012 and December
      2014 at Tokyo Medical University were retrospectively reviewed. Lesions treated
      by conventional ESD (n = 185) and by ESD with DFC (ESD-DFC) (n = 53) were
      compared. Multivariable analyses and propensity score matching were used to
      compensate for the differences in age, sex, resected specimen size, lesion
      location, lesion position, presence of ulceration, and operator level. The
      procedure time, rate of en bloc and complete resection, and rates of adverse
      events were evaluated between the 2 groups. RESULTS: Propensity score matching
      analysis created 43 matched pairs. Adjusted comparisons between ESD-DFC and
      conventional ESD showed similar treatment outcomes (en bloc resection rate: 97.7%
      vs 100%, P = .315; complete resection rate: 90.7% vs 95.3%, P = .397; perforation
      during ESD rate: 2.3% vs 2.3%, P = 1.000; post-ESD bleeding rate: 4.7% vs 4.7%, P
      = 1.000) but a significantly shorter procedure time for ESD-DFC (82.2 +/- 79.5
      minutes vs 118.2 +/- 71.6 minutes, P = .002). CONCLUSION: ESD-DFC facilitated
      rapid ESD with good visualization and traction while ensuring high curability and
      safety.
CI  - Copyright (c) 2016 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Suzuki, Sho
AU  - Suzuki S
AD  - Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo,
      Japan.
FAU - Gotoda, Takuji
AU  - Gotoda T
AD  - Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo,
      Japan.
FAU - Kobayashi, Yoshiyuki
AU  - Kobayashi Y
AD  - Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo,
      Japan.
FAU - Kono, Shin
AU  - Kono S
AD  - Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo,
      Japan.
FAU - Iwatsuka, Kunio
AU  - Iwatsuka K
AD  - Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo,
      Japan.
FAU - Yagi-Kuwata, Naoko
AU  - Yagi-Kuwata N
AD  - Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo,
      Japan.
FAU - Kusano, Chika
AU  - Kusano C
AD  - Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo,
      Japan.
FAU - Fukuzawa, Masakatsu
AU  - Fukuzawa M
AD  - Endoscopy Center, Tokyo Medical University Hospital, Tokyo, Japan.
FAU - Moriyasu, Fuminori
AU  - Moriyasu F
AD  - Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo,
      Japan.
LA  - eng
PT  - Journal Article
PT  - Video-Audio Media
DEP - 20150828
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
MH  - Adenocarcinoma/diagnosis/*surgery
MH  - Aged
MH  - Aged, 80 and over
MH  - *Dental Devices, Home Care
MH  - Dissection/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Gastric Mucosa/pathology/*surgery
MH  - Gastroscopy/*methods
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/prevention & control
MH  - Propensity Score
MH  - Retrospective Studies
MH  - Stomach Neoplasms/diagnosis/*surgery
MH  - *Surgical Instruments
MH  - Traction
MH  - Treatment Outcome
EDAT- 2015/09/01 06:00
MHDA- 2016/10/21 06:00
CRDT- 2015/09/01 06:00
PHST- 2015/03/17 00:00 [received]
PHST- 2015/07/17 00:00 [accepted]
PHST- 2015/09/01 06:00 [entrez]
PHST- 2015/09/01 06:00 [pubmed]
PHST- 2016/10/21 06:00 [medline]
AID - S0016-5107(15)02660-7 [pii]
AID - 10.1016/j.gie.2015.07.014 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2016 Feb;83(2):337-46. doi: 10.1016/j.gie.2015.07.014. Epub 
      2015 Aug 28.