Τετάρτη 17 Ιανουαρίου 2018

Usefulness of the S–O clip for gastric endoscopic submucosal dissection (with video)

Abstract

Background

Endoscopic submucosal dissection (ESD) is technically one of the most complicated endoscopic procedures. Traction methods have been reported to be effective for ESD. A recent study revealed that the S–O clip allowed faster and safer colonic ESD. We assessed the efficacy and safety of gastric ESD with the S–O clip for gastric epithelial neoplasm.

Methods

We performed a retrospective cohort study of patients treated for gastric ESD using the S–O clip between September and November 2016 (SO group, n = 48). The subjects were matched with patients treated with conventional gastric ESD from September 2015 to August 2016 (control group, n = 258) at Sendai Kousei Hospital, a tertiary endoscopic center. The primary outcome was procedure time. Multivariate logistic regression and propensity score matching analyses were performed to reduce the effects of selection bias for potential confounding factors differences like age, sex, lesion location, lesion position, presence of ulcer scarring, resected specimen size, and operator experiences.

Results

Forty-eight pairs were created after propensity score matching. The mean procedure time (including the S–O clip attachment time) was significantly shorter in the SO group (47.2 ± 24.6 vs. 69.2 ± 67.1 min, p = 0.035). The mean clip attachment time was 4.4 (range 2–15) min. There were no significant differences in other treatment outcomes (en-bloc resection rate: 100 vs. 100%, p = 1.000; perforation rate: 0 vs. 2.1%, p = 0.315; delayed bleeding rate: 2.1 vs. 4.3%, p = 0.558).

Conclusions

The S–O clip improved the speed of gastric ESD by approximately 25%, without increasing adverse events.



from Endoscopy via xlomafota13 on Inoreader http://ift.tt/2B9DyLq
via IFTTT

Δεν υπάρχουν σχόλια:

Δημοσίευση σχολίου

Σημείωση: Μόνο ένα μέλος αυτού του ιστολογίου μπορεί να αναρτήσει σχόλιο.