|Table of Contents|

Application of rubber band traction assisted technique in endoscopic submucosal dissection of early esophageal cancer

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 13
Page:
2463-2466
Research Field:
Publishing date:

Info

Title:
Application of rubber band traction assisted technique in endoscopic submucosal dissection of early esophageal cancer
Author(s):
XIE WenfuWEI MingyongSHI XiaoqiongPENG XueHE MeilinSHU Qiao
Department of Gastroenterology,Sichuan Science City Hospital,Sichuan Mianyang 621900,China.
Keywords:
early esophageal carcinomaendoscopic submucosal dissectiona rubber banddental flosstraction aid
PACS:
R735.1
DOI:
10.3969/j.issn.1672-4992.2023.13.016
Abstract:
Objective:To observe the clinical value of rubber band traction assisted technique in endoscopic submucosal dissection of early esophageal cancer.Methods:A total of 86 patients with early esophageal cancer admitted to our hospital from January 2020 to May 2022 were selected,all of whom underwent endoscopic submucosal dissection(ESD).They were divided into dental floss group(43 cases,floss traction aid) and rubber band group(43 cases,rubber band traction aid) by random number table method.The perioperative indexes and stress indexes of preoperative,postoperative 1,3 d between the two groups were compared.The surgical results,intraoperative and postoperative complications and follow-up results between the two groups were compared.Results:Compared with the dental floss group,the operation time was shorter,the times of injection and withdrawal,supplementary injection were less,and the rate of tourniquet disengagement was lower in rubber band group(P<0.05).On day 1 and 3 after surgery,compared with the dental floss group,the levels of serum cortisol(Cor),prostaglandin E2(PEG2) and substance P(SP) in rubber band group were lower(P<0.05).All patients underwent ESD surgery,and the lump resection rate of whole block,complete resection rate and one-time radical resection rate of dental floss group lesions were 100%,100% and 97.67%,respectively,and one case did not achieve one-time radical resection due to deep submucosal invasive carcinoma.The resection rate of whole block,complete resection rate and one-time radical resection rate in rubber band group were all 100%.All patients did not have heavy bleeding or perforation during surgery,and no stenosis occurred after surgery.All patients were followed up until November 2022,with a follow-up period of 6~34 months and a median follow-up of 16 months.In the dental floss group,one patient had surgery and radiotherapy at 14 months and there was no recurrence during follow-up.The rest of the patients did not develop lymph node metastasis or recurrence.Conclusion:The application of rubber band traction assistance technique in ESD of early esophageal cancer can shorten the operation time,relieve postoperative stress reduce the times of injection and withdrawl,reduce the number of supplementary injection,and the device is not easy to be detached.It can completely cure the lesion,and is safe and effective.

References:

[1] KANG YK,CHEN LT,RYU MH,et al.Nivolumab plus chemotherapy versus placebo plus chemotherapy in patients with HER2-negative,untreated,unresectable advanced or recurrent gastric or gastro-oesophageal junction cancer(ATTRACTION-4):a randomised,multicentre,double-blind,placebo-controlled,phase 3 trial[J].Lancet Oncol,2022,23(2):234-247.
[2] CODIPILLY DC,WANG KK.Squamous cell carcinoma of the esophagus[J].Gastroenterol Clin North Am,2022,51(3):457-484.
[3] PIMENTEL-NUNES P,LIB NIO D,BASTIAANSEN BAJ,et al.Endoscopic submucosal dissection for superficial gastrointestinal lesions:European Society of Gastrointestinal Endoscopy(ESGE) Guideline - Update 2022[J].Endoscopy,2022,54(6):591-622.
[4] NAGATA M.Optimal traction direction in traction-assisted gastric endoscopic submucosal dissection[J].World J Gastrointest Endosc,2022,14(11):667-671.
[5] 张义元.消化系统疾病诊断与治疗[M].天津:天津科学技术出版社,2010:15-16. ZHANG YY.Diagnosis and treatment of digestive system diseases [M].Tianjin:Tianjin Science and Technology Press,2010:15-16.
[6] MIKHAEL M,PASHA B,CHELA H,et al.Immunological and metabolic alterations in esophageal cancer[J].Endocr Metab Immune Disord Drug Targets,2022,22(6):579-589.
[7] MAROM G.Esophageal cancer staging[J].Thorac Surg Clin,2022,32(4):437-445.
[8] 王志新,周波,孙培胜,等.食管癌治疗后早期和晚期死亡的预测因素[J].胃肠病学和肝病学杂志,2022,31(6):638-647. WANG ZX,ZHOU B,SUN PS,et al.Predictors of early and late death after treatment for esophageal cancer [J].J Gastroenterology & Hepatology,2022,31(6):638-647.
[9] LIU X,GUO W,SHI X,et al.Construction and verification of prognostic nomogram for early-onset esophageal cancer[J].Bosn J Basic Med Sci,2021,21(6):760-772.
[10] KWOK K,TRAN T,LEW D.Polypectomy for large polyps with endoscopic mucosal resection[J].Gastrointest Endosc Clin N Am,2022,32(2):259-276.
[11] OH CK,CHO YW,CHOI IH,et al.Comparison of precutting endoscopic mucosal resection and endoscopic submucosal dissection for large(20-30 mm) flat colorectal lesions[J].J Gastroenterol Hepatol,2022,37(3):568-575.
[12] 陈振道,陈浩.内镜黏膜下剥离术治疗结肠神经内分泌肿瘤的效果[J].现代肿瘤医学,2016,24(15):2415-2418. CHEN ZD,CHEN H.Endoscopic submucosal dissection for the treatment of colon neuroendocrine neoplasm[J].Modern Oncology,2016,24(15):2415-2418.
[13] 庄惠军,沈许德,陈进忠,等.牙线牵引辅助内镜黏膜下剥离术治疗胃角黏膜病变的疗效(含视频)[J].中华消化内镜杂志,2020,37(9):642-646. ZHUANG HJ,SHEN XD,CHEN JZ,et al.Effect of dental floss assisted endoscopic submucosal dissection on gastric mucosal lesions [J].Chin J of Digestive Endoscopy,2020,37(9):642-646.
[14] 邝继孙,陈文妹,孔灿灿,等.经口牙线牵引辅助内镜下黏膜剥离术治疗早期胃癌的效果及学习曲线分析[J].局解手术学杂志,2020,29(4):288-292. KUANG JS,CHEN WM,KONG CC,et al.Effect and learning curve analysis of mucosal dissection assisted by oral floss traction in the treatment of early gastric cancer [J].J of Local Surgical Surgery,2020,29(4):288-292.
[15] 刘晓,王燕斌,于剑锋,等.新型牵引装置在结直肠侧向发育型肿瘤内镜黏膜下剥离术中的有效性研究[J].中华消化内镜杂志,2020,37(12):874-879. LIU X,WANG YB,YU JF,et al.Effect of a new type of traction device on endoscopic submucosal dissection of lateral colorectal tumors [J].Chin J of Digestive Endoscopy,2020,37(12):874-879.
[16] YOSHIMOTO T,SHIRATORI Y,IKEYA T.Combination of rubber band traction and partial injection for effective under-gel endoscopic mucosal resection of an ileocecal valve lesion[J].Video GIE,2022,7(3):112-114.
[17] 刘冠伊,戎龙,郭新月,等.橡皮圈组织夹内牵引辅助在内镜黏膜下剥离术治疗结直肠病变中的应用(含视频)[J].中华消化内镜杂志,2021,38(7):545-550. LIU GY,RONG L,GUO XY,et al.Application of rubber band tissue clip assisted traction in endoscopic submucosal dissection in the treatment of colorectal lesions [J].Chin J of Digestive Endoscopy,2021,38(7):545-550.
[18] CHANG MC,TSENG CL,HSU CH,et al.Rubber band-clip traction for endoscopic submucosal dissection involving the appendiceal orifice-a video vignette[J].Colorectal Dis,2022,24(2):243-244.

Memo

Memo:
中国消化道早癌医生共同成长计划科研项目(编号:GTCZ-2020-SC-51-0017)
Last Update: 2023-05-31