Efficacy of Clutch Cutter for Standardizing Endoscopic Submucosal Dissection for Early Gastric Cancer: A Propensity Score-Matched Analysis.
Digestion
; 100(3): 201-209, 2019.
Article
in En
| MEDLINE
| ID: mdl-30522097
ABSTRACT
BACKGROUND/AIMS:
The purpose of this study was to evaluate the safety and efficacy of gastric endoscopic submucosal dissection (ESD) using the Clutch Cutter (CC), a scissor-type knife, compared with those of procedures using conventional devices.METHODS:
This single-center retrospective study evaluated 237 patients with early gastric cancer 83 who underwent ESD using the CC group and 154 who underwent ESD using the insulated-tip knife 2 (IT2 group). Clinicopathological features and technical outcomes were compared between the 2 groups using a propensity score-matched analysis.RESULTS:
In 61 pairs of matched patients, there was no significant difference in R0 resection, perforation, or postoperative bleeding between the CC and IT2 groups. Comparisons between the 2 groups showed similar treatment outcomes for an expert endoscopist. Nevertheless, there were significant differences between the 2 groups for nonexperts in terms of self-completion (61.7 and 24.5%, respectively, p < 0.001), mean procedure times (45 and 61 min, respectively, p = 0.002), and mean numbers of intraoperative bleeding points and bleeding points requiring hemostatic forceps (3 and 0 vs. 8 and 3, respectively, p < 0.001).CONCLUSION:
Better self-completion rates and shorter procedure times were noted for gastric ESD using the CC by nonexperts than for that using IT2, probably due to hemostatic efficacy.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Stomach Neoplasms
/
Gastroscopy
/
Postoperative Hemorrhage
/
Electrocoagulation
/
Endoscopic Mucosal Resection
Type of study:
Etiology_studies
/
Evaluation_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Digestion
Year:
2019
Type:
Article