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KMID : 1038120220550060775
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Clinical Endoscopy
2022 Volume.55 No. 6 p.775 ~ p.783
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Endoscopic submucosal dissection in colorectal neoplasia performed with a waterjet system-assisted knife: higher en-bloc resection rate than conventional technique
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Cecinato Paolo
Lucarini Matteo
Azzolini Francesco
Campanale Mariachiara
Bassi Fabio
Cippitelli Annalisa
Sassatelli Romano
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Abstract
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Background/Aims : Colorectal endoscopic submucosal dissection (ESD) is burdened by its associated high risk of adverse events and long procedure time. Recently, a waterjet-assisted knife was introduced to simplify and speed up the procedure. The aim of this study was to evaluate the efficacy and safety of waterjet-assisted ESD (WESD) compared to that of the conventional ESD (CESD) technique.
Methods : The charts of 254 consecutive patients who underwent colorectal ESD between January 2014 and February 2021 for colorectal neoplasms were analyzed. The primary outcome was the en-bloc resection rate. Secondary outcomes were complete and curative resection rates, the need to switch to a hybrid ESD, procedure speed, the adverse event rates, and the recurrence rates.
Results : Approximately 174 neoplasias were considered, of which, 123 were removed by WESD and 51 by CESD. The en-bloc resection rate was higher in the WESD group (94.3% vs. 84.3%). Complete resection rates and curative resection rates were similar. The need to switch to a hybrid ESD was greater during CESD (39.2% vs. 13.8%). Procedure speed and adverse event rates were similar. During follow-up, one recurrence occurred after a WESD.
Conclusions : WESD allows a high rate of en-bloc resections and less frequently requires a rescue switch to the hybrid ESD compared to CESD.
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KEYWORD
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Colorectal adenoma, Colorectal cancer, Colorectal endoscopic submucosal dissection, Endoscopic submucosal dissection, HybridKnife
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