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Efficacy and safety comparison of scissor-type knives with needle-type knives for colorectal endoscopic submucosal dissection: a post-hoc propensity score-matched analysis (with videos).
Kuwai, Toshio; Oka, Shiro; Kamigaichi, Yuki; Tamaru, Yuzuru; Nagata, Shinji; Kunihiro, Masaki; Hiraga, Yuko; Furudoi, Akira; Onogawa, Seiji; Okanobu, Hideharu; Mizumoto, Takeshi; Miwata, Tomohiro; Okamoto, Shiro; Tanaka, Shinji.
Afiliación
  • Kuwai T; Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan.
  • Oka S; Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
  • Kamigaichi Y; Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
  • Tamaru Y; Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan.
  • Nagata S; Department of Gastroenterology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan.
  • Kunihiro M; Department of Internal Medicine, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan.
  • Hiraga Y; Department of Endoscopy, Hiroshima Prefectural Hospital, Hiroshima, Japan.
  • Furudoi A; Department of Gastroenterology, JA Hiroshima General Hospital, Hatsukaichi, Japan.
  • Onogawa S; Department of Gastroenterology, Onomichi General Hospital, Onomichi, Japan.
  • Okanobu H; Department of Gastroenterology, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima, Japan.
  • Mizumoto T; Department of Gastroenterology, Miyoshi Central Hospital, Miyoshi, Japan.
  • Miwata T; Department of Gastroenterology, Chugoku Rosai Hospital, Kure, Japan.
  • Okamoto S; Department of Gastroenterology, Kure Kyosai Hospital, Kure, Japan.
  • Tanaka S; Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan.
Gastrointest Endosc ; 96(1): 108-117, 2022 07.
Article en En | MEDLINE | ID: mdl-35247378
BACKGROUND AND AIMS: Many knives have been developed to improve the efficacy and safety of endoscopic submucosal dissection (ESD). We aimed to evaluate the efficacy and safety of scissor-type knives for colorectal ESD compared with needle-type knives. METHODS: We performed a post-hoc propensity score-matched analysis in an 11-facility study between August 2013 and December 2018. A total of 2330 patients (2498 lesions) who underwent colorectal ESD were divided into needle-type (1923 patients, 2067 lesions) and scissor-type (407 patients, 431 lesions) knife groups. Short-term outcomes were compared between the 2 groups. RESULTS: Two-to-one propensity score-matched analysis identified 814 (709 patients) and 407 (386 patients) lesions in the needle- and scissor-type knife groups, respectively. The median resection speed was significantly faster in the needle-type group (18.3 mm2/min) than in the scissor-type group (13.2 mm2/min, P < .0001), whereas en-bloc and histologic complete resection rates were not significantly different between the needle- and scissor-type groups (96.8% [788/814] vs 98.3% [400/407], P = .1888 and 95.1% [774/814] vs 95.6% [389/407], P = .7763, respectively). The rate of lesions resected using a single knife was significantly higher in the scissor-type group (98.5% [401/407]) than in the needle-type group (43.9% [357/814], P < .0001). Rates of intraoperative perforation and delayed bleeding were significantly lower in the scissor-type group than in the needle-type group (.7% [3/407] vs 2.5% [20/814], P = .0431 for each). CONCLUSIONS: Scissor-type knives are safer for colorectal ESD. However, they are associated with slower resection speeds compared with needle-type knives. (Clinical trial registration number: UMIN000016197.).
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Resección Endoscópica de la Mucosa Tipo de estudio: Observational_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Gastrointest Endosc Año: 2022 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Resección Endoscópica de la Mucosa Tipo de estudio: Observational_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Gastrointest Endosc Año: 2022 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos