Snare Tip Is an Alternative Tool for Colorectal Endoscopic Submucosal Dissection

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Oncology

Background:

• Colorectal endoscopic submucosal dissection (ESD) often utilizes specialized knives like the dual knife.
• Taiwan's National Health Insurance does not cover specialized knives for colorectal ESD.
• Literature primarily reports snare tip use for gastric ESD, not colorectal.

Purpose of the Study:

• To evaluate the outcomes of colorectal endoscopic submucosal dissection (ESD) performed with a snare tip.
• To compare the efficacy and safety of snare tip versus dual knife for colorectal ESD.

Main Methods:

• Retrospective review of colorectal ESD procedures comparing snare tip and dual knife.
• Inclusion of patients unable to afford specialized knives.
• Analysis of short-term outcomes (dissection time, speed, complications) and long-term outcomes (recurrence-free rate).

Main Results:

• Similar rates of en bloc resection, complications, and recurrence between snare tip and dual knife groups.
• Shorter dissection time but slower dissection speed observed with the snare tip.
• Dual knife group had a larger mean resected specimen diameter.

Conclusions:

• The snare tip serves as a practical alternative for colorectal ESD in patients without access to specialized knives.
• Despite slower dissection speed, the snare tip is a recommended technique for resource-limited settings or low-income patients.
• Further research with larger patient numbers may be beneficial.