Endoscopic submucosal dissection for early esophageal neoplasms using the stag beetle knife

Figure 1 Study design, evaluating the use of the stag beetle knife for esophageal endoscopic submucosal dissection. ESD: Endoscopic submucosal dissection; HGIN: High-grade intraepithelial neoplasia; SCC: Squamous cell carcinoma.

Figure 2 Features of the stag beetle Knife Jr and short devices.

Figure 3 Stag beetle knife used for esophageal endoscopic submucosal dissection in a 79-year-old man. Endoscopic appearance of a 35-mm, depressed lesion in the middle one-third of the esophagus (A) under white light (B) on a scatter image with Lugol’s iodine applied (C) with argon plasma coagulation markings; D and E: Use of the SB Knife Jr for full-circumferential incision; use of the SB Knife Short for (F) submucosal dissection and (G) hemostasis; H: En bloc resection of the lesion; I: Ulcer floor after resection.

Figure 4 Formalin-fixed specimen sliced at 2-mm intervals for routine processing and slide preparation (A); Evaluation of the histotype, invasion depth, and vertical/lateral resection margins (B-D).

Figure 5 Long-term outcomes and survival analysis. A: Cumulative metachronous cancer rates in patients with curative resection; B: Kaplan-Meier analysis of overall survival rates in all patients; C: Patients grouped according to curative and non-curative resection.