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2014-02

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Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/119054

Experimental study of hybrid-knife endoscopic submucosal dissection (ESD) versus standard ESD in a Western country

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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.

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Endoscòpia, Mucosa gastrointestinal, Cirurgia digestiva

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Endoscopy, Gastrointestinal mucosa, Gastrointestinal surgery

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Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

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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. Experimental study of hybrid-knife endoscopic submucosal dissection (ESD) versus standard ESD in a Western country. _Revista Española de Enfermedades Digestivas_. 2014. Vol. 106, núm. 2, pàgs. 98-102. [consulta: 21 de gener de 2026]. ISSN: 1130-0108. [Disponible a: https://hdl.handle.net/2445/119054]

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