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Efficacy of an endo-knife with a water-jet function (Flushknife) for endoscopic submucosal dissection of superficial colorectal neoplasms.
Takeuchi, Yoji; Uedo, Noriya; Ishihara, Ryu; Iishi, Hiroyasu; Kizu, Takashi; Inoue, Takuya; Chatani, Rika; Hanaoka, Noboru; Taniguchi, Tomoyasu; Kawada, Natsuko; Higashino, Koji; Shimokawa, Toshio; Tatsuta, Masaharu.
Afiliación
  • Takeuchi Y; Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan. takeuti-yo@mc.pref.osaka.jp
Am J Gastroenterol ; 105(2): 314-22, 2010 Feb.
Article en En | MEDLINE | ID: mdl-19773749
ABSTRACT

OBJECTIVES:

Endoscopic submucosal dissection (ESD) is currently not a common treatment for colorectal neoplasms because it is time consuming and technically difficult. Flushknife--an electrosurgical endo-knife with a water-jet function--is expected to reduce the difficulty of colorectal ESD. The objective of this study was to investigate the efficacy of a water-jet function for colorectal ESD.

METHODS:

This study was a prospective randomized controlled trial, which was conducted at a cancer referral center. A total of 49 patients, with a total of 51 superficial colorectal neoplasms (median tumor size of 30 mm), were enrolled and randomly assigned to undergo ESD using either the Flexknife (electrosurgical endo-knife without a water-jet function) or the Flushknife. Tumors were resected by ESD using each endo-knife. The procedures were conducted by two endoscopists. Operation time was defined as the main outcome measure.

RESULTS:

En bloc resection was achieved in 23 out of 26 (88%) lesions in the Flexknife group and in 24 out of 24 (100%) lesions in the Flushknife group. The mean operation time (95% confidence interval) was 87.3 (71.3-103.4) min in the Flexknife group and 61.0 (49.3-72.7) min in the Flushknife group (P=0.02). The Flushknife reduced the number of endoscopic device changes (P=0.001), the number of submucosal injections (P=0.001), and the mean amount of injected hyaluronate sodium (P=0.001) compared with the Flexknife. No severe adverse events were observed in either group.

CONCLUSIONS:

Without increasing adverse events, the endo-knife with a water-jet function efficiently reduced the operation time of colorectal ESD in patients with large superficial colorectal neoplasms. (University hospital Medical Information Network Clinical Trials Registry number UMIN000001302).
Asunto(s)

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Agua / Carcinoma / Neoplasias Colorrectales / Adenoma / Colonoscopía / Electrocirugia Tipo de estudio: Clinical_trials / Observational_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Gastroenterol Año: 2010 Tipo del documento: Article País de afiliación: Japón

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Agua / Carcinoma / Neoplasias Colorrectales / Adenoma / Colonoscopía / Electrocirugia Tipo de estudio: Clinical_trials / Observational_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Gastroenterol Año: 2010 Tipo del documento: Article País de afiliación: Japón