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01-02-2018

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

Authors: Rintaro Hashimoto, Dai Hirasawa, Tomoyuki Iwaki, Hajime Yamaoka, Kousuke Nihei, Ippei Tanaka, Akimichi Chonan, Kei Takase

Published in: Surgical Endoscopy | Issue 2/2018

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.

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Title: Usefulness of the S–O clip for gastric endoscopic submucosal dissection (with video)
Authors: Rintaro Hashimoto
Dai Hirasawa
Tomoyuki Iwaki
Hajime Yamaoka
Kousuke Nihei
Ippei Tanaka
Akimichi Chonan
Kei Takase
Publication date: 01-02-2018
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 2/2018
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-017-5765-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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