Colorectal endoscopic submucosal dissection using the pocket-creation method with single clip traction: a feasibility...

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Oncology

Background:

• The pocket-creation method (PCM) aids tumor dissection.
• Previous development of PCM with clip traction (PCM-CT) aimed to improve mucosal pocket opening during endoscopic submucosal dissection (ESD).
• Cumbersome mucosal pocket opening can be a challenge in colorectal ESD.

Purpose of the Study:

• To evaluate the feasibility of PCM-CT for colorectal endoscopic submucosal dissection (ESD).
• To assess the efficacy of PCM-CT in resecting early colorectal tumors.

Main Methods:

• PCM-CT was applied to 30 patients with early colorectal tumors.
• The technique involves dissecting the tumor center with PCM and applying single-clip traction after mucosal incision.
• Data collected included specimen size, ESD duration, resection speed, and en bloc resection rates.

Main Results:

• 100% en bloc resection rate was achieved in all 30 patients.
• Median specimen major axis length was 48 mm, with a median ESD time of 84 minutes.
• The traction clip succeeded in 100% of cases, with a median application time of 1.5 minutes.

Conclusions:

• Colorectal endoscopic submucosal dissection using PCM-CT is a simple and promising technique.
• PCM-CT facilitates efficient mucosal pocket opening and traction during ESD.
• The method demonstrates high efficacy and safety for early colorectal tumor resection.