RESUMO
BACKGROUND AND AIMS: Submucosal tunneling endoscopic septum division (STESD) is a valid endoscopic modality for treating esophageal diverticula. However, it requires highly skilled endoscopists. Here, we propose a modified STESD method. METHODS: This is a single-center, prospective case series. We consecutively enrolled 8 patients diagnosed with esophageal diverticula. All patients underwent the modified STESD by 1 experienced endoscopist. RESULTS: Only 1 patient had intraoperative bleeding, which was successfully stopped endoscopically. The mean ± standard deviation size of the diverticula was 3.16 ± 1.14 cm. The operation time ranged from 27 to 68 minutes, with a mean value of 40.88 minutes. The number of clips ranged from 4 to 8. The success rate was 100%. None of the patients had symptom recurrences during 2 to 25 months of follow-up. CONCLUSIONS: The modified STESD method for esophageal diverticula is effective and safe; further large prospective controlled studies are needed.
RESUMO
BACKGROUND AND AIMS: Colorectal endoscopic submucosal resection (ESD), especially ESD in proximal colon, has always been challenging. We invented a novel elastic ring as a traction method to facilitate ESD. Our study aims to compare the safety and effectiveness of ESD with in vivo traction and conventional ESD without traction in the treatment of large proximal colon neoplastic lesions. METHODS: This retrospective cohort study included consecutive patients with large (≥ 20 mm in their maximal diameter) proximal colon neoplastic lesions who underwent ESD with in vivo elastic ring traction or conventional ESD without traction in our endoscopy center between June 2018 and April 2022 by one experienced endoscopist. RESULTS: The ESD with traction group has lower overall complication rate and lower perforation rate than those in the conventional ESD group (0% vs 14.71%, P = 0.021; 0% vs 11.76%, P = 0.048, respectively), and the differences are statistically significant. Although there are no significant differences in the rates of en bloc resection and R0 resection and bleeding rate, ESD with traction group still had higher en bloc resection and R0 resection rates and lower bleeding rate than conventional ESD group without traction (100% vs 94.12%, P = 0.226; 94.59% vs 85.29%, P = 0.189, 8.82% vs 2.70%, P = 0.276, respectively). CONCLUSION: ESD with elastic ring traction is potentially more effective and safer than conventional ESD in the treatment of large proximal colon neoplastic lesions. Further large, prospective controlled studies are needed to fully evaluate this novel method.