Sequential injection-electrocoagulation vs. traditional electrocoagulation haemostasis during endoscopic submucosal...

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Surgical Hemostasis

Background:

• Traditional electrocoagulation is standard for hemostasis during endoscopic submucosal dissection (ESD).
• Bleeding during ESD can impair visualization and increase risks of complications like muscle injury and perforation.

Purpose of the Study:

• To evaluate the efficacy and safety of a novel sequential injection-electrocoagulation technique during upper gastrointestinal ESD.
• To compare this new method against traditional electrocoagulation in a randomized controlled trial.

Main Methods:

• A randomized controlled trial involving 69 patients undergoing upper gastrointestinal ESD.
• Patients were assigned to either traditional electrocoagulation (control) or sequential injection-electrocoagulation (experimental).
• Bleeding point visibility was scored by endoscopists from 1 (undetectable) to 4 (easily detectable).

Main Results:

• The experimental group achieved hemostasis faster (median 17s vs. 22s, P < 0.001).
• Visibility scores were significantly higher in the experimental group (3.24 ± 0.63 vs. 2.82 ± 0.57, P < 0.001).
• Muscle injuries (P = 0.003) and one perforation occurred more frequently in the control group.

Conclusions:

• The sequential injection-electrocoagulation strategy is more effective for hemostasis during ESD.
• This method improves operative field visibility and reduces procedure-related risks.
• The findings support the adoption of sequential injection-electrocoagulation for safer ESD procedures.