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Gastroenterology Research and Practice
Volume 2016, Article ID 3186168, 7 pages
http://dx.doi.org/10.1155/2016/3186168
Research Article

Esophageal Endoscopic Submucosal Dissection Assisted by an Overtube with a Traction Forceps: An Animal Study

1Department of Gastroenterology, NTT Medical Center Tokyo, Tokyo 141-8625, Japan
2Department of Endoscopy, Kanma Memorial Hospital, Nasushiobara 325-0046, Japan
3Department of Gastroenterology, Kyorin University School of Medicine, Tokyo 181-8611, Japan
4Department of Gastroenterology, Keiyu Hospital, Yokohama 220-0012, Japan
5Department of Gastroenterology, University of Tokyo, Tokyo 113-8655, Japan
6Department of Gastroenterology, Omori Red Cross Hospital, Tokyo 143-8527, Japan
7Division of Gastroenterology, Department of Internal Medicine, Yokkaichi Municipal Hospital, Yokkaichi 510-0822, Japan
8Department of Gastroenterology, Moriguchi Keijinkai Hospital, Osaka 570-0021, Japan
9Department of Gastroenterology, Yamaga Chuo Hospital, Yamaga 861-0501, Japan
10Department of Diagnostic Pathology, NTT Medical Center Tokyo, Tokyo 141-8625, Japan

Received 22 March 2016; Revised 17 June 2016; Accepted 27 June 2016

Academic Editor: Ronnie Fass

Copyright © 2016 Ken Ohata et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Esophageal endoscopic submucosal dissection (ESD) is technically difficult. To make it safer, we developed a novel method using overtube with a traction forceps (OTF) for countertraction during submucosal dissection. We conducted an ex vivo animal study and compared the clinical outcomes between OTF-ESD and conventional method (C-ESD). A total of 32 esophageal ESD procedures were performed by four beginner and expert endoscopists. After circumferential mucosal incision for the target lesion, structured as the isolated pig esophagus 3 cm long, either C-ESD or OTF-ESD was randomly selected for submucosal dissection. All the ESD procedures were completed as en bloc resections, while perforation only occurred in a beginner’s C-ESD procedure. The dissection time for OTF-ESD was significantly shorter than that for C-ESD for both the beginner and expert endoscopists ( min versus  min, , and  min versus  min, , resp.). The frequency and volume of the submucosal injections were significantly smaller for OTF-ESD than for C-ESD ( times versus times, , and  mL versus  mL, , resp.). Histologically, muscular injury was more common among the C-ESD procedures (80% versus 13%, ). Our results indicated that the OTF-ESD technique is useful for the safe and easy completion of esophageal ESD.