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Published on: February 10, 2017
Percutaneous transgastric traction-assisted esophageal endoscopic submucosal dissection: a randomized controlled
Peng-Jen Chen1, Wen-Chien Huang, Hsiu-Po Wang
1Division of Gastroenterology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Objectives:
Endoscopic submucosal dissection (ESD) is a technically difficult, hazardous, and time-consuming treatment option for superficial neoplasms of the esophagus. The aim of this pilot study was to determine the effectiveness and safety of percutaneous transgastric traction (PTT)-assisted ESD, a method that overcomes the drawbacks of conventional ESD, in a porcine model.
Methods:
Six domestic pigs (25-30 kg) were used in the study. In each animal, two 5-cm-long esophageal areas were assigned randomly for resection by conventional ESD or PTT-assisted ESD. The PTT method was designed to offer esophageal mucosal traction directed toward the stomach. The wire was introduced into the stomach through a percutaneous transgastric cannula and was fixed on the resected esophageal mucosa.
Results:
Submucosal dissection in the traction group required only half the time of that in the non-traction group (mean dissection time 596.0 vs. 1127.3 s, respectively; p = 0.01). At necropsy, no differences in the incidence of perforation or bleeding were found between two groups.
Conclusions:
The PTT method can enhance the speed of submucosal dissection for esophageal ESD to completely remove large areas of resected mucosa.
