Journal of Gastric Cancer

  • 제23권4호
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  • Pages.512-522
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  • 2023
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  • 2093-582X(pISSN)
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  • 2093-5641(eISSN)
대한위암학회 (The Korean Gastric Cancer Association)
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Indications for Dental Floss Clip Traction During Gastric Endoscopic Submucosal Dissection by Less-Experienced Endoscopists

  • Hirosato Tamari (Department of Endoscopy, Hiroshima University Hospital) ;
  • Shiro Oka (Department of Gastroenterology, Hiroshima University Hospital) ;
  • Takahiro Kotachi (Department of Gastroenterology, Hiroshima University Hospital) ;
  • Hajime Teshima (Department of Endoscopy, Hiroshima University Hospital) ;
  • Junichi Mizuno (Department of Endoscopy, Hiroshima University Hospital) ;
  • Motomitsu Fukuhara (Department of Endoscopy, Hiroshima University Hospital) ;
  • Hidenori Tanaka (Department of Gastroenterology, Hiroshima University Hospital) ;
  • Akiyoshi Tsuboi (Department of Gastroenterology, Hiroshima University Hospital) ;
  • Ken Yamashita (Department of Gastroenterology, Hiroshima University Hospital) ;
  • Ryo Yuge (Department of Gastroenterology, Hiroshima University Hospital) ;
  • Yuji Urabe (Division of Regeneration and Medicine Center for Translational and Clinical Research, Hiroshima University Hospital) ;
  • Yasuhiko Kitadai (Department of Health and Science, Prefectural University of Hiroshima) ;
  • Koji Arihiro (Department of Anatomical Pathology, Hiroshima University Hospital) ;
  • Shinji Tanaka (Department of Endoscopy, Hiroshima University Hospital)
  • 투고 : 2022.08.28
  • 심사 : 2022.12.28
  • 발행 : 2023.10.31
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초록

Purpose: Dental floss clip (DFC) traction-assisted endoscopic submucosal dissection (ESD) is widely performed owing to its simplicity. This study aimed to clarify the appropriate indications for the DFC traction method in early gastric cancer when ESD is performed by less-experienced endoscopists. Methods and Methods: We retrospectively analyzed 1,014 consecutive patients who had undergone gastric ESD performed by less-experienced endoscopists between January 2015 and December 2020. Gastric ESD was performed without DFC in all cases before December 2017 [DFC (-) group, 376 cases], and ESD was performed with DFC in all cases after January 2018 [DFC (+) group, 436 cases]. The procedure time and rates of en bloc resection, complete resection, and adverse events of the groups were compared. Results: The procedure time did not differ significantly between the 2 groups. However, when comparing lesions >20 mm, the procedure time in the DFC (+) group was significantly shorter than that in the DFC (-) group (95±46 vs. 75±31, P<0.01). The procedure time for lesions located in the greater curvature of the upper or middle stomach and lesions >20 mm located in the lesser curvature side of the stomach in the DFC (+) group was significantly shorter than that in the DFC (-) group. Conclusions: The indications for DFC during gastric ESD by less-experienced endoscopists include lesions located in the greater curvature of the upper or middle stomach, and lesions >20 mm located in the lesser curvature of the stomach.

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참고문헌

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