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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2016; 22(26): 5917-5926
Published online Jul 14, 2016. doi: 10.3748/wjg.v22.i26.5917
Recent traction methods for endoscopic submucosal dissection
Kunihiro Tsuji, Naohiro Yoshida, Hiroyoshi Nakanishi, Kenichi Takemura, Shinya Yamada, Hisashi Doyama
Kunihiro Tsuji, Naohiro Yoshida, Hiroyoshi Nakanishi, Kenichi Takemura, Shinya Yamada, Hisashi Doyama, Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa 920-8530, Japan
Author contributions: Tsuji K and Doyama H wrote the paper; Nakanishi H, Yoshida N, Takemura K and Yamada S contributed to revision of the manuscript for important content.
Conflict-of-interest statement: No conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hisashi Doyama, MD, PhD, Department of Gastroenterology, Ishikawa Prefectural Central Hospital, 2-1 Kuratukihigashi, Kanazawa, Ishikawa 920-8530, Japan. doyama.134@ipch.jp
Telephone: +81-76-2378211 Fax: +81-76-2385366
Received: March 26, 2016
Peer-review started: March 28, 2016
First decision: May 27, 2016
Revised: June 5, 2016
Accepted: June 15, 2016
Article in press: June 15, 2016
Published online: July 14, 2016
Abstract

Endoscopic mucosal resection (EMR) is problematic with regard to en bloc and curable resection rates. Advancements in endoscopic techniques have enabled novel endoscopic approaches such as endoscopic submucosal dissection (ESD), which has overcome some EMR problems, and has become the standard treatment for gastrointestinal tumors. However, ESD is technically difficult. Procedure time is longer and complications such as intraoperative perforation and bleeding occur more frequently than in EMR. Recently various traction methods have been introduced to facilitate ESD procedures, such as clip with line, external forceps, clip and snare, internal traction, double scope, and magnetic anchor. Each method must be used appropriately according to the anatomical characteristics. In this review we discuss recently proposed traction methods for ESD based on the characteristics of various anatomical sites.

Keywords: Endoscopic submucosal dissection, Traction, Pharyngeal cancer, Esophageal cancer, Gastric cancer, Colorectal cancer

Core tip: Endoscopic submucosal dissection (ESD) is technically one of the most difficult endoscopic procedures. Recently, traction methods have been introduced to facilitate ESD procedures, various types of which have been proposed. Each traction method must be used appropriately according to anatomical characteristics. We discuss recently proposed traction methods for ESD based on the characteristics of various anatomical sites.