Copyright
©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
Clutch Cutter knife efficacy in endoscopic submucosal dissection for early gastric neoplasms
Yasuyo Hayashi, Mitsuru Esaki, Sho Suzuki, Eikichi Ihara, Azusa Yokoyama, Seiichiro Sakisaka, Taizo Hosokawa, Yoshimasa Tanaka, Takahiro Mizutani, Shinichi Tsuruta, Aya Iwao, Shun Yamakawa, Akira Irie, Yosuke Minoda, Yoshitaka Hata, Haruei Ogino, Hirotada Akiho, Yoshihiro Ogawa
Yasuyo Hayashi, Mitsuru Esaki, Eikichi Ihara, Yosuke Minoda, Yoshitaka Hata, Haruei Ogino, Yoshihiro Ogawa, Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
Yasuyo Hayashi, Azusa Yokoyama, Seiichiro Sakisaka, Taizo Hosokawa, Yoshimasa Tanaka, Takahiro Mizutani, Hirotada Akiho, Department of Gastroenterology, Kitakyushu Municipal Medical Center, Kitakyushu 802-0077, Japan
Mitsuru Esaki, Sho Suzuki, Aya Iwao, Shun Yamakawa, Akira Irie, Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Itabashi-ku 173-8610, Japan
Shinichi Tsuruta, Department of Anatomic Pathology, Graduate School of Medical Sciences Kyushu University, Fukuoka 812-8582, Japan
Author contributions: Hayashi Y and Esaki M designed the research, drafted the article and revised the article for important intellectual content; Yokoyama A, Sakisaka S, Hosokawa T, Tanaka Y, Mizutani T and Ogino H analysised and interpreted the data; Suzuki S, Iwao A, Yamakawa S, Irie A, Minoda Y, Hata Y, Akiho H and Ihara E critical revised of the manuscript for important intellectual content; Ogawa Y supervised the whole process; all authors have read and approved the final version to be published.
Institutional review board statement: This study was conducted according to the ethical principles of the Declaration of Helsinki, and each institution’s review board and ethical committee approved the study’s protocol.
Informed consent statement: The patients had signed the informed consent.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Open-Access: This 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 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/
Corresponding author to: Mitsuru Esaki, MD, Doctor, Research Associate, Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1, Oyaguchikami-cho, Tokyo, Itabashi-ku 173-8610, Japan. esaki_saiseikai@yahoo.co.jp
Telephone: +81-3-32938111 Fax: +81-3-32938111
Received: September 11, 2018
Peer-review started: September 11, 2018
First decision: October 5, 2018
Revised: October 15, 2018
Accepted: November 7, 2018
Article in press: November 8, 2018
Published online: December 15, 2018
ARTICLE HIGHLIGHTS
Research background
Endoscopic submucosal dissection (ESD) is the standard treatment for early gastric neoplasms with negligible lymph node metastasis. However, it is a complex and difficult procedure. Many types of endo-knives have been invented and developed to improve the ESD procedure.
Research motivation
The Clutch Cutter is a novel scissor-type endo-knife, which may contribute to facilitating the ESD procedure. However, few studies have compared the technical outcomes of each knife.
Research objectives
The aim of this study was to compare the technical outcomes between ESD with the Clutch Cutter and ESD with other devices.
Research methods
Patients with early gastric neoplasms treated by ESD at Kitakyushu Municipal Medical Center between April 2016 and October 2017 were reviewed. ESD was performed using the Clutch Cutter (ESD-C group) or other devices (ESD-O group). Propensity score matching analysis was conducted to compensate for confounding differences between the two groups that may affect the outcomes. After matching, the technical outcomes of ESD were compared among the two groups.
Research results
A total of 155 patients were included and 44 pairs were matched. ESD with the Clutch Cutter achieved a significantly shorter procedure time (median, 49 min vs 88.5 min, P < 0.001). The other technical outcomes and complication rates were similar among the two groups.
Research conclusions
The Clutch Cutter contributed to shortening the ESD’s procedure time. ESD with the Clutch Cutter could be an effective option in ESD with endo-knives for early gastric neoplasms.
Research perspectives
This was a single-center, retrospective study with a relatively small number of ESD cases. Therefore, further large-scale, randomized, prospective studies are needed.
