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Usefulness of the clip-and-snare method using the pre-looping technique for endoscopic submucosal dissection of gastric neoplasia: a randomized controlled trial

BACKGROUND: The clip-and-snare method using the pre-looping technique (CSM-PLT) was developed as a traction method for endoscopic submucosal dissection (ESD) of gastric neoplasia. However, its usefulness has not been clearly established; thus, we aimed to assess the efficacy of CSM-PLT in gastric ES...

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Autores principales: Hasatani, Kenkei, Yoshida, Naohiro, Aoyagi, Hiroyuki, Utsunomiya, Manami, Naito, Yoshihide, Matano, Yutaka, Tominaga, Kei, Waseda, Yohei, Doyama, Hisashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hellenic Society of Gastroenterology 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8713345/
https://www.ncbi.nlm.nih.gov/pubmed/34987288
http://dx.doi.org/10.20524/aog.2021.0679
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author Hasatani, Kenkei
Yoshida, Naohiro
Aoyagi, Hiroyuki
Utsunomiya, Manami
Naito, Yoshihide
Matano, Yutaka
Tominaga, Kei
Waseda, Yohei
Doyama, Hisashi
author_facet Hasatani, Kenkei
Yoshida, Naohiro
Aoyagi, Hiroyuki
Utsunomiya, Manami
Naito, Yoshihide
Matano, Yutaka
Tominaga, Kei
Waseda, Yohei
Doyama, Hisashi
author_sort Hasatani, Kenkei
collection PubMed
description BACKGROUND: The clip-and-snare method using the pre-looping technique (CSM-PLT) was developed as a traction method for endoscopic submucosal dissection (ESD) of gastric neoplasia. However, its usefulness has not been clearly established; thus, we aimed to assess the efficacy of CSM-PLT in gastric ESD. METHODS: In this multicenter, randomized controlled trial, patients with gastric adenoma or carcinoma with absolute or expanded indications for ESD were randomized into conventional ESD and CSM-PLT groups, using the minimization method based on operator experience, tumor location, tumor size, and excision device. The primary endpoint was ESD procedure time. Secondary endpoints were en bloc and R0 resection rates, and complications. RESULTS: We enrolled 402 patients between July 2017 and February 2020. After excluding patients with deviations from the protocol, we finally analyzed the data of 192 and 186 patients in the conventional and CSM-PLT groups, respectively. The procedure time was significantly shorter in the CSM-PLT group than in the conventional group (58.0 vs. 69.7 min; P=0.009). All lesions were resected en bloc. The R0 resection rate tended to be higher in the CSM-PLT group (P=0.09). No significant differences in complications were observed between the 2 groups. CONCLUSIONS: CSM-PLT is beneficial for gastric ESD when compared with the conventional technique. CSM-PLT significantly reduced procedure times and improved R0 resection rates.
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spelling pubmed-87133452022-01-04 Usefulness of the clip-and-snare method using the pre-looping technique for endoscopic submucosal dissection of gastric neoplasia: a randomized controlled trial Hasatani, Kenkei Yoshida, Naohiro Aoyagi, Hiroyuki Utsunomiya, Manami Naito, Yoshihide Matano, Yutaka Tominaga, Kei Waseda, Yohei Doyama, Hisashi Ann Gastroenterol Original Article BACKGROUND: The clip-and-snare method using the pre-looping technique (CSM-PLT) was developed as a traction method for endoscopic submucosal dissection (ESD) of gastric neoplasia. However, its usefulness has not been clearly established; thus, we aimed to assess the efficacy of CSM-PLT in gastric ESD. METHODS: In this multicenter, randomized controlled trial, patients with gastric adenoma or carcinoma with absolute or expanded indications for ESD were randomized into conventional ESD and CSM-PLT groups, using the minimization method based on operator experience, tumor location, tumor size, and excision device. The primary endpoint was ESD procedure time. Secondary endpoints were en bloc and R0 resection rates, and complications. RESULTS: We enrolled 402 patients between July 2017 and February 2020. After excluding patients with deviations from the protocol, we finally analyzed the data of 192 and 186 patients in the conventional and CSM-PLT groups, respectively. The procedure time was significantly shorter in the CSM-PLT group than in the conventional group (58.0 vs. 69.7 min; P=0.009). All lesions were resected en bloc. The R0 resection rate tended to be higher in the CSM-PLT group (P=0.09). No significant differences in complications were observed between the 2 groups. CONCLUSIONS: CSM-PLT is beneficial for gastric ESD when compared with the conventional technique. CSM-PLT significantly reduced procedure times and improved R0 resection rates. Hellenic Society of Gastroenterology 2022 2021-12-06 /pmc/articles/PMC8713345/ /pubmed/34987288 http://dx.doi.org/10.20524/aog.2021.0679 Text en Copyright: © Hellenic Society of Gastroenterology https://creativecommons.org/licenses/by-nc-sa/3.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Hasatani, Kenkei
Yoshida, Naohiro
Aoyagi, Hiroyuki
Utsunomiya, Manami
Naito, Yoshihide
Matano, Yutaka
Tominaga, Kei
Waseda, Yohei
Doyama, Hisashi
Usefulness of the clip-and-snare method using the pre-looping technique for endoscopic submucosal dissection of gastric neoplasia: a randomized controlled trial
title Usefulness of the clip-and-snare method using the pre-looping technique for endoscopic submucosal dissection of gastric neoplasia: a randomized controlled trial
title_full Usefulness of the clip-and-snare method using the pre-looping technique for endoscopic submucosal dissection of gastric neoplasia: a randomized controlled trial
title_fullStr Usefulness of the clip-and-snare method using the pre-looping technique for endoscopic submucosal dissection of gastric neoplasia: a randomized controlled trial
title_full_unstemmed Usefulness of the clip-and-snare method using the pre-looping technique for endoscopic submucosal dissection of gastric neoplasia: a randomized controlled trial
title_short Usefulness of the clip-and-snare method using the pre-looping technique for endoscopic submucosal dissection of gastric neoplasia: a randomized controlled trial
title_sort usefulness of the clip-and-snare method using the pre-looping technique for endoscopic submucosal dissection of gastric neoplasia: a randomized controlled trial
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8713345/
https://www.ncbi.nlm.nih.gov/pubmed/34987288
http://dx.doi.org/10.20524/aog.2021.0679
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