Prospective, randomized study of conventional versus HybridKnife endoscopic submucosal dissection methods for the esophagus: An animal study

Norio Fukami, Chang Beom Ryu, Sherif Said, Zachary Weber, Yang K. Chen

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: Endoscopic submucosal dissection (ESD) increases en bloc and histologically complete resection rate of neoplastic mucosal tumors but is technically more demanding than EMR. Limited data are available comparing the efficacy and safety of a new ESD designed to overcome these limitations and conventional ESD (C-ESD) techniques. Objective: To compare the safety, efficacy, and operation time of the new HybridKnife ESD (HK-ESD) with C-ESD in the esophagus. Design: Prospective, randomized, controlled study. Setting: Animal research laboratory. Subjects: Seventeen anesthetized Yorkshire pigs. Interventions: Removal of a 4-cm length of half-circumference esophageal mucosa by C-ESD with Hook knife or Flexknife versus HK-ESD. Main Outcome Measurements: Procedure time, en bloc and complete resection rate, and complications (bleeding and perforation). Results: All resections were completed en bloc. Procedure time was shorter in C-ESD. However, it was similar after 12 procedures. Significantly more bleeding occurred during C-ESD (28 vs 12, P = .0007). Histological muscularis propria injuries occurred with equal frequency (16 vs 17) and were mostly seen during the first 11 procedures. There were 3 perforations (2 endoscopic, 1 histological), all with C-ESD. Limitations: Nonsurvival study, use of 2 conventional knives, no training period for a new procedure. Conclusions: The HK-ESD technique was equally effective as the C-ESD technique for successful en bloc resection and was safer with less bleeding and perforation. Although procedure time was longer in HK-ESD, the difference became nonsignificant after 12 procedures.

Original languageEnglish (US)
Pages (from-to)1246-1253
Number of pages8
JournalGastrointestinal Endoscopy
Volume73
Issue number6
DOIs
StatePublished - Jun 1 2011
Externally publishedYes

Fingerprint

Esophagus
Prospective Studies
Hemorrhage
Safety
Endoscopic Mucosal Resection
Swine
Wounds and Injuries
Neoplasms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Prospective, randomized study of conventional versus HybridKnife endoscopic submucosal dissection methods for the esophagus : An animal study. / Fukami, Norio; Ryu, Chang Beom; Said, Sherif; Weber, Zachary; Chen, Yang K.

In: Gastrointestinal Endoscopy, Vol. 73, No. 6, 01.06.2011, p. 1246-1253.

Research output: Contribution to journalArticle

@article{e5971b8d17e54411a72b577b393a0cb2,
title = "Prospective, randomized study of conventional versus HybridKnife endoscopic submucosal dissection methods for the esophagus: An animal study",
abstract = "Background: Endoscopic submucosal dissection (ESD) increases en bloc and histologically complete resection rate of neoplastic mucosal tumors but is technically more demanding than EMR. Limited data are available comparing the efficacy and safety of a new ESD designed to overcome these limitations and conventional ESD (C-ESD) techniques. Objective: To compare the safety, efficacy, and operation time of the new HybridKnife ESD (HK-ESD) with C-ESD in the esophagus. Design: Prospective, randomized, controlled study. Setting: Animal research laboratory. Subjects: Seventeen anesthetized Yorkshire pigs. Interventions: Removal of a 4-cm length of half-circumference esophageal mucosa by C-ESD with Hook knife or Flexknife versus HK-ESD. Main Outcome Measurements: Procedure time, en bloc and complete resection rate, and complications (bleeding and perforation). Results: All resections were completed en bloc. Procedure time was shorter in C-ESD. However, it was similar after 12 procedures. Significantly more bleeding occurred during C-ESD (28 vs 12, P = .0007). Histological muscularis propria injuries occurred with equal frequency (16 vs 17) and were mostly seen during the first 11 procedures. There were 3 perforations (2 endoscopic, 1 histological), all with C-ESD. Limitations: Nonsurvival study, use of 2 conventional knives, no training period for a new procedure. Conclusions: The HK-ESD technique was equally effective as the C-ESD technique for successful en bloc resection and was safer with less bleeding and perforation. Although procedure time was longer in HK-ESD, the difference became nonsignificant after 12 procedures.",
author = "Norio Fukami and Ryu, {Chang Beom} and Sherif Said and Zachary Weber and Chen, {Yang K.}",
year = "2011",
month = "6",
day = "1",
doi = "10.1016/j.gie.2010.12.004",
language = "English (US)",
volume = "73",
pages = "1246--1253",
journal = "Gastrointestinal Endoscopy",
issn = "0016-5107",
publisher = "Mosby Inc.",
number = "6",

}

TY - JOUR

T1 - Prospective, randomized study of conventional versus HybridKnife endoscopic submucosal dissection methods for the esophagus

T2 - An animal study

AU - Fukami, Norio

AU - Ryu, Chang Beom

AU - Said, Sherif

AU - Weber, Zachary

AU - Chen, Yang K.

PY - 2011/6/1

Y1 - 2011/6/1

N2 - Background: Endoscopic submucosal dissection (ESD) increases en bloc and histologically complete resection rate of neoplastic mucosal tumors but is technically more demanding than EMR. Limited data are available comparing the efficacy and safety of a new ESD designed to overcome these limitations and conventional ESD (C-ESD) techniques. Objective: To compare the safety, efficacy, and operation time of the new HybridKnife ESD (HK-ESD) with C-ESD in the esophagus. Design: Prospective, randomized, controlled study. Setting: Animal research laboratory. Subjects: Seventeen anesthetized Yorkshire pigs. Interventions: Removal of a 4-cm length of half-circumference esophageal mucosa by C-ESD with Hook knife or Flexknife versus HK-ESD. Main Outcome Measurements: Procedure time, en bloc and complete resection rate, and complications (bleeding and perforation). Results: All resections were completed en bloc. Procedure time was shorter in C-ESD. However, it was similar after 12 procedures. Significantly more bleeding occurred during C-ESD (28 vs 12, P = .0007). Histological muscularis propria injuries occurred with equal frequency (16 vs 17) and were mostly seen during the first 11 procedures. There were 3 perforations (2 endoscopic, 1 histological), all with C-ESD. Limitations: Nonsurvival study, use of 2 conventional knives, no training period for a new procedure. Conclusions: The HK-ESD technique was equally effective as the C-ESD technique for successful en bloc resection and was safer with less bleeding and perforation. Although procedure time was longer in HK-ESD, the difference became nonsignificant after 12 procedures.

AB - Background: Endoscopic submucosal dissection (ESD) increases en bloc and histologically complete resection rate of neoplastic mucosal tumors but is technically more demanding than EMR. Limited data are available comparing the efficacy and safety of a new ESD designed to overcome these limitations and conventional ESD (C-ESD) techniques. Objective: To compare the safety, efficacy, and operation time of the new HybridKnife ESD (HK-ESD) with C-ESD in the esophagus. Design: Prospective, randomized, controlled study. Setting: Animal research laboratory. Subjects: Seventeen anesthetized Yorkshire pigs. Interventions: Removal of a 4-cm length of half-circumference esophageal mucosa by C-ESD with Hook knife or Flexknife versus HK-ESD. Main Outcome Measurements: Procedure time, en bloc and complete resection rate, and complications (bleeding and perforation). Results: All resections were completed en bloc. Procedure time was shorter in C-ESD. However, it was similar after 12 procedures. Significantly more bleeding occurred during C-ESD (28 vs 12, P = .0007). Histological muscularis propria injuries occurred with equal frequency (16 vs 17) and were mostly seen during the first 11 procedures. There were 3 perforations (2 endoscopic, 1 histological), all with C-ESD. Limitations: Nonsurvival study, use of 2 conventional knives, no training period for a new procedure. Conclusions: The HK-ESD technique was equally effective as the C-ESD technique for successful en bloc resection and was safer with less bleeding and perforation. Although procedure time was longer in HK-ESD, the difference became nonsignificant after 12 procedures.

UR - http://www.scopus.com/inward/record.url?scp=79957820490&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79957820490&partnerID=8YFLogxK

U2 - 10.1016/j.gie.2010.12.004

DO - 10.1016/j.gie.2010.12.004

M3 - Article

C2 - 21316668

AN - SCOPUS:79957820490

VL - 73

SP - 1246

EP - 1253

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

IS - 6

ER -