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KMID : 0359020080360060341
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Korean Journal of Gastrointestinal Endoscopy
2008 Volume.36 No. 6 p.341 ~ p.348
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Traction with using a Rubber Band and Clips for Effective Endoscopic Submucosal Dissection
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Lee Bo-In
Kim Byung-Wook
Choi Hwang
Ji Jeong-Seon
Chung Woo-Chul
Lee Kang-Moon
Lee In-Seok
Kim Jin-Il
Choi Myung-Gyu
Choi Gyu-Yong
Chung In-Sik
Maeng Lee-So
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Abstract
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Background/Aims: Traction with using a rubber band and clips may be helpful for performing endoscopic submucosal dissection (ESD) by keeping adequate tissue tension and satisfactory submucosal exposure.
Methods: 17 patients with noninvasive neoplasias or intramucosal cancers (16 gastric lesions and 1 colonic lesion) were included to evaluate this technique’s feasibility (3), because of a difficult location for dissection (11), unsatisfactory mucosal elevation despite adequate submucosal injection (2), and a high risk of perforation from the thin colonic wall (1). Submucosal dissection was performed after traction was applied, with a using a rubber band and clips, to a precut margin of the lesion.
Results: The mean sizes of the 16 gastric neoplasias and the corresponding resected specimens were 16±9 mm (6∼40) and 37±9 mm (18∼50), respectively, and the sizes of the colonic intramucosal cancers and the resected specimens were 41 mm and 51 mm), respectively. Both the en-bloc resection rate and the complete resection rate were 77%. Complete ESD without snaring was preformed in 10 cases (59%). The traction was assessed as useful in eleven cases (65%), not useful in two (12%), and annoying in four (23%).
Conclusions: Traction with using a rubber band and clips can be useful for performing ESD. (Korean J Gastrointest Endosc 2008;36:341-348)
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KEYWORD
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Endoscopicsubmucosaldissection, Traction, Complication, Gastricneoplasms, Colorectalneoplasms
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