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Related Experiment Video

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Endoscopic submucosal dissection for large colorectal neoplasms.

Kenichiro Imai1, Kinichi Hotta1, Yuichiro Yamaguchi1

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Summary

The ITknife nano™ is a feasible tool for endoscopic submucosal dissection (ESD) of large colorectal neoplasms (>50 mm), offering faster resection times. This study assessed its safety and efficacy in these challenging cases.

Keywords:
adenomacolonoscopycolorectal neoplasmendoscopic mucosal resectionendoscopic submucosal dissection

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Area of Science:

  • Gastroenterology
  • Endoscopic Surgery
  • Oncology

Background:

  • Endoscopic submucosal dissection (ESD) for large colorectal neoplasms (>50 mm) presents technical challenges.
  • The ITknife nano™ was developed for ESD of colorectal neoplasms (CRN) and esophageal superficial neoplasms.
  • Limited data exist on the ITknife nano™'s utility in large CRN ESD.

Purpose of the Study:

  • To assess the safety and efficacy of ESD using the ITknife nano™ for large CRN (>50 mm).
  • To compare en bloc/curative resection rates, complications, and resection speed with and without the ITknife nano™.

Main Methods:

  • Retrospective study of 177 patients with CRN >50 mm treated with ESD (September 2002 - August 2016).
  • Comparison of ESD using ITknife nano™ versus Dual knife™ only.
  • Analysis of en bloc/curative resection rates, complications, and resection speed.

Main Results:

  • In 133 CRN treated with ITknife nano™, en bloc and curative resection rates were 96.2% and 80.5%.
  • Complications included perforation (6.0%) and delayed bleeding (3.0%), both managed endoscopically.
  • Resection speed was significantly faster with ITknife nano™ (25.3 mm²/min) compared to Dual knife™ only (19.9 mm²/min; P=0.02).

Conclusions:

  • The ITknife nano™ is feasible for ESD of large CRN (>50 mm).
  • It may lead to reduced procedure times.
  • Further controlled studies are warranted to confirm these findings.