Published online Jul 16, 2017. doi: 10.4253/wjge.v9.i7.334
Peer-review started: November 2, 2016
First decision: December 1, 2016
Revised: January 20, 2017
Accepted: March 23, 2017
Article in press: March 24, 2017
Published online: July 16, 2017
To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) using the clutch cutter (CC) (ESD-CC) for gastric adenoma (GA).
From June 2007 to August 2015, 122 consecutive patients with histological diagnoses of GA from specimens resected by ESD-CC were enrolled in this prospective study. The CC was used for all ESD steps (marking, mucosal incision, submucosal dissection, and hemostatic treatment), and its therapeutic efficacy and safety were assessed.
Both the en-bloc resection rate and the R0 resection rate were 100% (122/122). The mean surgical time was 77.4 min, but the time varied significantly according to tumor size and location. No patients suffered perforation. Post-ESD-CC bleeding occurred in six cases (4.9%) that were successfully resolved by endoscopic hemostatic treatment.
ESD-CC is a technically efficient, safe, and easy method for resecting GA.
Core tip: The clutch cutter (CC) was developed to reduce risk of complications related to endoscopic submucosal dissection (ESD) using conventional knives. The CC can grasp, pull, coagulate and/or incise targeted tissue using electrosurgical current, as with a bite biopsy. The CC can be used in all ESD steps (marking, mucosal incision, submucosal dissection, and hemostatic treatment). ESD using the CC (ESD-CC) for gastric adenoma (GA) gave a 100% R0 resection rate in this study, with no perforation. ESD-CC is a technically efficient, safe, and easy method for resecting GA.