Related Experiment Video
Updated: Apr 21, 2026
The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors
Published on: February 13, 2026
Usefulness of the thread-traction method in esophageal endoscopic submucosal dissection: randomized controlled trial
Yoshiki Koike1, Dai Hirasawa, Naotaka Fujita
1Department of Gastroenterology, Sendai City Medical Center, Sendai, Japan.
Background And Aim:
To assess the usefulness of the thread-traction method (TT method) in esophageal endoscopic submucosal dissection (ESD).
Methods:
A total of 40 lesions that were scheduled to be treated by esophageal ESD were included in the study. The TT method was used for 20 lesions (group TT) and conventional ESD was used for 20 lesions (group C) after randomization. The hook-knife method was used in all cases. In group TT, after circumferential mucosal incision, a clip with thread was attached to the oral edge of the lesion.
Results:
ESD was carried out in all cases. Effective countertraction was created by the TT method, and it was possible to carry out an efficient dissection operation. Significant shortening of dissection time was achieved in group TT compared with group C (19.8 min vs 31.8 min, P = 0.044). Mean number of local injections during dissection was significantly less in group TT compared with that in group C (0.6 times vs 2.2 times, P < 0.001). As for the amount of local injection, group TT required significantly less compared with group C (2.6 mL vs 7.5 mL, P < 0.01). No complications were encountered.
Conclusion:
The TT method in esophageal ESD was safe and contributed to shortening of dissection time. The TT method is expected to become widespread as a safe and useful procedure.
