Basic Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Oct 16, 2023; 15(10): 584-592
Published online Oct 16, 2023. doi: 10.4253/wjge.v15.i10.584
Magnetic anchor technique assisted endoscopic submucosal dissection for early esophageal cancer
Min Pan, Miao-Miao Zhang, Shu-Qin Xu, Yi Lyu, Xiao-Peng Yan
Min Pan, Miao-Miao Zhang, Shu-Qin Xu, Yi Lyu, Xiao-Peng Yan, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Min Pan, Department of Thoracic Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Miao-Miao Zhang, Shu-Qin Xu, Yi Lyu, Xiao-Peng Yan, National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Author contributions: Lyu Y and Yan XP conceived and designed the study; Pan M and Zhang MM performed the research and acquired the data; Xu SQ wrote the manuscript; Pan M and Zhang MM revised the manuscript; Lyu Y and Yan XP examined the final manuscript; and all authors read and approved the final manuscript.
Supported by the Key Research & Development Program-Social Development of Shaanxi Province of China, No. 2021SF-163; and the Innovation Capability Support Plan of Shaanxi Province of China, No. 2020KJXX-022.
Institutional animal care and use committee statement: All animal experiments conformed to the internationally accepted principles for the laboratory animal care committee of Xi’an Jiaotong University (approval NO. XJTULAC2019-1006) and were in accordance with the ethical standards for experimental animals of Xi’an Jiaotong University.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
ARRIVE guidelines statement: The authors have read the ARRIVE guidelines, and the manuscript was prepared and revised according to the ARRIVE guidelines.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Peng Yan, MD, PhD, Associate Research Scientist, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277 West Yanta Road, Xi’an 710061, Shaanxi Province, China. yanxiaopeng9966@163.com
Received: August 19, 2023
Peer-review started: August 19, 2023
First decision: August 31, 2023
Revised: September 12, 2023
Accepted: September 25, 2023
Article in press: September 25, 2023
Published online: October 16, 2023
ARTICLE HIGHLIGHTS
Research background

Esophageal cancer has high incidence and poor prognosis globally. Endoscopic submucosal dissection (ESD) has become the standard therapy for managing early tumors of the esophagus, stomach, and colon. However, there are some deficiencies, such as a steep learning curve, difficult operation, and technically demanding nature of the procedure. Magnetic anchor technique (MAT) is a brand new ESD assistance technique to improve the procedure of ESD.

Research motivation

Although ESD has become the golden treatment for early esophageal cancer, some limitations such as a steep learning curve and plenty of complications can still significantly improve. It already had some assisted techniques, which had trouble in controlling and maintaining tissue tension. The magnetic anchor device designed by our own is aspired to solve the problems mentioned above.

Research objectives

This study aims to testify the feasibility and safety of MAT-assisted ESD for early esophageal cancer.

Research methods

The experimental model used in this study was isolated pig esophagi, and the magnetic anchor device was designed by us, consisting of three parts: Target magnet (TM), anchor target (AM) and soft tissue clip. It was divided into two groups, namely the operational and control groups, and 10 endoscopists completed the procedure. In the operational group, the soft tissue clip together with the TM was connected by a thin wire through a small hole at the tail end of the TM, and was clamped to the edge of the lesioned mucosa, which was marked in advance. By changing the position of the AM outside the esophagus, the pulling force and pulling direction of the TM could be changed, thus exposing the mucosal peeling surface and assisting the ESD. The two groups were evaluated for the following aspects by SPSS: The total operative time, perforation rate, rate of whole mucosal resection, diameter of the peering mucosa, and scores of endoscopists’ feelings with the procedure, including the convenience, mucosal surface exposure degree, and tissue tension.

Research results

The two groups did not significantly differ in the diameter of the peering mucosa, perforation rate and rate of whole mucosal resection. In the operational group, the TM remained firmly connected with the soft tissue clip and did not affect the opening, closing, and release of the soft tissue clip. The interaction between the TM and AM could provide sufficient tissue tension and completely expose the mucosa, which greatly assisted the endoscopists’ feelings with the operation, which were higher in the operational group than in the control group in terms of the convenience (9.22 ± 0.19 vs 8.34 ± 0.15, P = 0.002), mucosal surface exposure degree (9.11 ± 0.15 vs 8.25 ± 0.12, P < 0.001), and tissue tension (9.35 ± 0.13 vs 8.02 ± 0.17, P < 0.001). In addition, the total operative time was shorter in the operational group than in the control group.

Research conclusions

The MAT-assisted ESD was safe and feasible for early esophageal cancer.

Research perspectives

With the development of further internal animal experiments and the accumulation of operational experience, this technique has broad clinical application prospects.