The effects of different traction devices on colorectal endoscopic submucosal dissection outcomes

Endoscopic submucosal dissection (ESD) enables en bloc resection of large colorectal lesions, but it remains challenging due to thin walls and poor operability. Traction devices like SureClip traction band (SCTB, Micro-tech) and SO clip (SO-C, Zeon Medical Inc.) are used to address this. This study compared the differences in ESD outcomes between SCTB and SO-C.

Comparative analysis of the efficacy of SO-C and SCTB for various therapeutic results, including procedure time in colorectal ESD.

A single-center retrospective study reviewed 982 colorectal ESD procedures for lesions 20-49 mm performed at Kyoto Prefectural University of Medicine from January 2015 to November 2024.

Patients were categorized into no-traction, SCTB, and SO-C groups. Propensity score matching was performed to minimize baseline differences. The primary outcome was ESD procedure time, and secondary outcomes assessed various therapeutic results.

After matching, there were no differences in procedure time (56.0 ± 31.2 vs 59.8 ± 30.6 min, p = 0.206), en bloc resection (97.7% vs 98.3%, p = 0.589), and perioperative perforation (0.3% vs 1.4%, p = 0.101) between the traction (SCTB + SO-C) and no-traction groups. Regarding the comparison between the SCTB and SO-C groups after matching, there were no significant differences regarding ESD procedure time (58.7 ± 37.4 vs 59.1 ± 31.9 min, p = 0.469), en bloc resection (97.4% vs 97.4%, p = 1.000), and perioperative perforation (0% vs 0.9%, p = 0.316). The SCTB deployment was significantly faster than the SO-C (6.3 ± 3.8 vs 9.3 ± 5.9 min, p = 0.004).

There were no significant differences in ESD therapeutic results between SCTB and SO-C, while the SCTB had a faster deployment time.