Facilitating endoscopic submucosal dissection: the suture-pulley method significantly improves procedure time and minimizes technical difficulty compared with conventional technique: an ex vivo study (with video)

医学 滑轮 四分位间距 纤维接头 外科 内镜黏膜下剥离术 解剖(医学) 机械工程 工程类
作者
Hiroyuki Aihara,Nitin Kumar,Marvin Ryou,Wasif M. Abidi,Michele B. Ryan,Christopher C. Thompson
出处
期刊:Gastrointestinal Endoscopy [Elsevier BV]
卷期号:80 (3): 495-502 被引量:44
标识
DOI:10.1016/j.gie.2014.01.050
摘要

Background The lack of countertraction in endoscopic submucosal dissection (ESD) results in increased technical demand and procedure time. Although the suture-pulley method for countertraction has been reported, its effectiveness compared with the traditional ESD technique remains unclear. Objective To objectively analyze efficacy of countertraction using the suture-pulley method for ESD. Design Prospective ex vivo animal study. Setting Animal laboratory. Interventions Twenty simulated gastric lesions were created in porcine stomachs by using a standard circular template 30 mm in diameter. In the control arm (n = 10), ESD was performed by using the standard technique. In the suture-pulley arm (N = 10), a circumferential incision was made, and an endoscopic suturing device was used to place the suture pulley. Main Outcome Measurements The primary outcome of this study was total procedure time. Results The median total procedure time with the suture-pulley method was significantly shorter than the traditional ESD technique (median, 25% to 75%, interquartile range [IQR]: 531 seconds [474.3-549.3 seconds] vs 845 seconds [656.3-1547.5 seconds], P < .001). The median time (IQR) for suture-pulley placement was 160.5 seconds (150.0-168.8 seconds). Although there was a significantly longer procedure time for proximal versus middle/lower stomach lesions with traditional ESD (median, 1601 seconds; IQR, 1547.5-1708.8 seconds vs median, 663 seconds; IQR, 627.5-681.8 seconds; P = .01), there was no significant difference in procedure time for lesions of various locations when using the suture-pulley method. Compared with traditional ESD, the suture-pulley method was less demanding in all categories evaluated by the NASA Task Load Index. Limitations Ex vivo study. Conclusions The suture-pulley method facilitates direct visualization of the submucosal layer during ESD and significantly reduces procedure time and technical difficulty. In addition, the benefit of the suture-pulley method was seen for both simple and more complicated ESDs. The lack of countertraction in endoscopic submucosal dissection (ESD) results in increased technical demand and procedure time. Although the suture-pulley method for countertraction has been reported, its effectiveness compared with the traditional ESD technique remains unclear. To objectively analyze efficacy of countertraction using the suture-pulley method for ESD. Prospective ex vivo animal study. Animal laboratory. Twenty simulated gastric lesions were created in porcine stomachs by using a standard circular template 30 mm in diameter. In the control arm (n = 10), ESD was performed by using the standard technique. In the suture-pulley arm (N = 10), a circumferential incision was made, and an endoscopic suturing device was used to place the suture pulley. The primary outcome of this study was total procedure time. The median total procedure time with the suture-pulley method was significantly shorter than the traditional ESD technique (median, 25% to 75%, interquartile range [IQR]: 531 seconds [474.3-549.3 seconds] vs 845 seconds [656.3-1547.5 seconds], P < .001). The median time (IQR) for suture-pulley placement was 160.5 seconds (150.0-168.8 seconds). Although there was a significantly longer procedure time for proximal versus middle/lower stomach lesions with traditional ESD (median, 1601 seconds; IQR, 1547.5-1708.8 seconds vs median, 663 seconds; IQR, 627.5-681.8 seconds; P = .01), there was no significant difference in procedure time for lesions of various locations when using the suture-pulley method. Compared with traditional ESD, the suture-pulley method was less demanding in all categories evaluated by the NASA Task Load Index. Ex vivo study. The suture-pulley method facilitates direct visualization of the submucosal layer during ESD and significantly reduces procedure time and technical difficulty. In addition, the benefit of the suture-pulley method was seen for both simple and more complicated ESDs.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
DrW完成签到,获得积分10
刚刚
隐形曼青应助yue采纳,获得10
1秒前
ccyy完成签到 ,获得积分10
1秒前
NexusExplorer应助腾腾腾采纳,获得10
2秒前
宿帅帅完成签到,获得积分10
3秒前
3秒前
Ningxin完成签到,获得积分10
3秒前
HHEHK发布了新的文献求助10
3秒前
柚子完成签到 ,获得积分10
3秒前
雨辰完成签到,获得积分10
5秒前
宿帅帅发布了新的文献求助10
5秒前
量子星尘发布了新的文献求助10
8秒前
8秒前
熠熠完成签到,获得积分10
8秒前
9秒前
zxzb完成签到,获得积分10
11秒前
苹果萧完成签到 ,获得积分10
14秒前
宋江他大表哥完成签到,获得积分10
14秒前
able发布了新的文献求助10
14秒前
王先生完成签到 ,获得积分10
15秒前
H.发布了新的文献求助10
15秒前
luoluo完成签到,获得积分10
16秒前
16秒前
高分子完成签到,获得积分10
16秒前
yian发布了新的文献求助10
17秒前
yar应助体贴凌柏采纳,获得10
18秒前
自由的雪一完成签到,获得积分10
18秒前
Ava应助李振博采纳,获得200
18秒前
JW发布了新的文献求助10
19秒前
无限的千凝完成签到 ,获得积分10
20秒前
CipherSage应助YeeYee采纳,获得10
20秒前
20秒前
Ander完成签到 ,获得积分10
21秒前
化白完成签到,获得积分10
22秒前
H.完成签到,获得积分10
22秒前
chuzihang完成签到 ,获得积分10
22秒前
科研小狗完成签到,获得积分10
28秒前
11完成签到,获得积分10
29秒前
柏林寒冬应助QAQ采纳,获得10
31秒前
Flynn完成签到 ,获得积分10
33秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038303
求助须知:如何正确求助?哪些是违规求助? 3576013
关于积分的说明 11374210
捐赠科研通 3305780
什么是DOI,文献DOI怎么找? 1819322
邀请新用户注册赠送积分活动 892672
科研通“疑难数据库(出版商)”最低求助积分说明 815029