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http://hdl.handle.net/2445/119054
Title: | Experimental study of hybrid-knife endoscopic submucosal dissection (ESD) versus standard ESD in a Western country |
Author: | Peña, Joaquín de la Calderón, Ángel Esteban, José M. López Rosés, Leopoldo Martínez Ares, David Nogales, Óscar Orive Calzada, Aitor Rodríguez Muñoz, Sarbelio Sánchez Hernández, Eloy Vila, Juan Fernández Esparrach, Glòria |
Keywords: | Endoscòpia Mucosa gastrointestinal Cirurgia digestiva Endoscopy Gastrointestinal mucosa Gastrointestinal surgery |
Issue Date: | Feb-2014 |
Publisher: | Aran Ediciones |
Abstract: | BACKGROUND: Endoscopic submucosal dissection (ESD) is an effective but time-consuming treatment for early neoplasia that requires a high level of expertise. OBJECTIVE: The objective of this study was to assess the efficacy and learning curve of gastric ESD with a hybrid knife with high pressure water jet and to compare with standard ESD. MATERIAL AND METHODS: We performed a prospective non survival animal study comparing hybrid-knife and standard gastric ESD. Variables recorded were: Number of en-bloc ESD, number of ESD with all marks included (R0), size of specimens, time and speed of dissection and adverse events. Ten endoscopists performed a total of 50 gastric ESD (30 hybrid-knife and 20 standard). RESULTS: Forty-six (92 %) ESD were en-bloc and 25 (50 %) R0 (hybrid-knife: n = 13, 44 %; standard: n = 16, 80 %; p = 0.04). Hybrid-knife ESD was faster than standard (time: 44.6 +/- 21.4 minutes vs. 68.7 +/- 33.5 minutes; p = 0.009 and velocity: 20.8 +/- 9.2 mm(2)/min vs. 14.3 +/- 9.3 mm(2)/min (p = 0.079). Adverse events were not different. There was no change in speed with any of two techniques (hybrid-knife: From 20.33 +/- 15.68 to 28.18 +/- 20.07 mm(2)/min; p = 0.615 and standard: From 6.4 +/- 0.3 to 19.48 +/- 19.21 mm(2)/min; p = 0.607). The learning curve showed a significant improvement in R0 rate in the hybrid-knife group (from 30 % to 100 %). CONCLUSION: despite the initial performance of hybrid-knife ESD is worse than standard ESD, the learning curve with hybrid knife ESD is short and is associated with a rapid improvement. The introduction of new tools to facilitate ESD should be implemented with caution in order to avoid a negative impact on the results. |
Note: | Reproducció del document publicat a: |
It is part of: | Revista Española de Enfermedades Digestivas, 2014, vol. 106, num. 2, p. 98-102 |
URI: | http://hdl.handle.net/2445/119054 |
ISSN: | 1130-0108 |
Appears in Collections: | Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) Articles publicats en revistes (Medicina) |
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