Scissor-Type Knife Improves Trainee's Self-Completion of Endoscopic Submucosal Dissection for Early Gastric Cancer

Area of Science:

• Gastroenterology
• Surgical Oncology
• Medical Devices

Background:

• Endoscopic submucosal dissection (ESD) is a key technique for early gastric cancer (EGC).
• The efficacy of specific instruments in ESD training requires further investigation.
• This study evaluates the utility of a scissor-type knife in ESD procedures.

Purpose of the Study:

• To assess the efficacy of a scissor-type knife in gastric endoscopic submucosal dissection (ESD).
• To compare the self-completion rates of trainees using scissor-type knives versus non-scissor devices.
• To evaluate procedure time and complication rates associated with scissor-type knife use in ESD.

Main Methods:

• Retrospective analysis of 903 early gastric cancer (EGC) lesions treated with ESD between April 2014 and March 2022.
• Comparison of trainee self-completion rates between ESD using a scissor-type knife (ESD-SC) and non-scissor devices (ESD-NS).
• Multivariate analysis to identify factors influencing trainee self-completion rates in gastric ESD.

Main Results:

• Trainee self-completion rates were significantly higher with ESD-SC (50.3%) compared to ESD-NS (33.0%) (p < 0.001).
• Procedure times were significantly shorter for ESD-SC (50.0 min) than ESD-NS (66.5 min) (p < 0.001).
• No significant difference in intraoperative perforation rates was observed between ESD-SC (0.6%) and ESD-NS (1.4%).

Conclusions:

• A scissor-type knife is associated with improved trainee performance in gastric ESD, evidenced by higher self-completion rates and reduced procedure times.
• Factors such as tumor location, tumor size, and the use of a scissor-type knife significantly influenced trainee self-completion rates.
• Further prospective studies are recommended to confirm the clinical utility of scissor-type knives in ESD training.