Related Experiment Video
Updated: Jan 9, 2026
Laparoscopy-endoscopy Cooperative Surgery for the Treatment of Gastric Gastrointestinal Stromal Tumors
Published on: February 19, 2022
EndoTrac-Assisted vs. Conventional ESD in Superficial Gastric Neoplasms: A Multicenter Randomized Controlled Trial
Ryosuke Ishida1, Tomoya Sako2, Yoshinobu Yamamoto3
1Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Introduction:
Endoscopic submucosal dissection (ESD) is a technically demanding curative treatment for early gastric cancer. The EndoTrac traction device was designed to enhance maneuverability during ESD. This study evaluated whether EndoTrac-assisted ESD (ET-ESD) improves outcomes versus conventional ESD (C-ESD) in patients with superficial gastric neoplasms.
Methods:
In this multicenter, single-blind, randomized controlled trial, 142 patients from 11 Japanese centers were assigned to undergo ET-ESD (n = 72) or C-ESD (n = 70). The primary endpoint was ESD procedure time. Secondary endpoints included efficacy, safety, and device-related outcomes. Operator experience, lesion characteristics, knife type, and institutional ESD volume were recorded and analyzed.
Results:
Median procedure times were 53.5 min for ET-ESD and 57.0 for C-ESD (p = 0.56). Among trainees, ET-ESD was associated with a shorter procedure time than C-ESD (59.0 vs. 85.5 min; p = 0.02). In subgroup analyses of trainee cases, shorter times with ET-ESD were associated with several scenarios (e.g., lesions ≤20 mm, upper/middle third of the lesser curvature, needle-type knife, and low-volume centers). In a multivariable analysis among trainees, ET-ESD remained independently associated with shorter procedure time (B = -24.8 min; 95% CI: -43.8 to -5.8; p = 0.012). In the overall cohort, en bloc and R0 resection rates, adverse events, and device-related complications were similar between groups.
Conclusion:
ET-ESD did not significantly shorten procedure time in the overall cohort. Nonetheless, exploratory subgroup analyses suggested potential benefits among trainees, small lesions, technically challenging locations, and low-volume centers.
