A Water-Jet Videoendoscope May Reduce Operation Time of Endoscopic Submucosal Dissection for Early Gastric Cancer

作者：Tatsumi Koichi; Uedo Noriya^*; Ishihara Ryu; Yamamoto Sachiko; Yamamoto Shunsuke; Masuda Eriko; Kato Motohiko; Takeuchi Yoji; Higashino Koji; Iishi Hiroyasu; Kurokawa Yukinori; Tatsuta Masaharu

来源：Digestive Diseases and Sciences, 2012, 57(8): 2122-2129.

DOI：10.1007/s10620-012-2138-z

• Surgical endoscopy
• Endoscopic surgical procedures
• Endoscopic submucosal dissection
• Gastric cancer

One of the problems with endoscopic submucosal dissection (ESD) for early gastric cancer is that it prolongs procedure time considerably.
The purpose of this study was to investigate whether a videoendoscope with water-jet function shortened the time of ESD for early gastric cancer.
A total of 82 early gastric cancers that were intramucosal, differentiated-type adenocarcinoma a parts per thousand currency sign2 cm, without ulcer or scar, in 75 consecutive patients were investigated. Three supervised resident endoscopists participated as operators. After stratification by the operator and tumor location, the lesions were randomly assigned to the water-jet videoendoscope or a conventional videoendoscope groups. An insulated tipped knife was used for the ESD procedure. Total operation time was evaluated as a primary endpoint.
The median (25-75th percentile) total operation time for the water-jet videoendoscope group was 51 (33-87) minutes, which was shorter than the 62 (43-88) minutes for the conventional videoendoscope, but it did not reach significance (P = 0.201). Multivariate analysis revealed that the water-jet videoendoscope (OR 3.0, P = 0.046), tumor size a parts per thousand currency sign14 mm (OR 3.2, P = 0.040) and antral tumor (OR 4.5, P = 0.046) were significantly associated with short (a parts per thousand currency sign60 min) operation time.
The water-jet videoendoscope may reduce operation time of ESD for early gastric cancer, compared with conventional videoendoscope. A large-scale multicenter trial is warranted to clarify the efficacy of the water-jet videoendoscope for gastric ESD.

• 出版日期2012-8