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Endoscopic submucosal dissection for rectal carcinoid tumour using the C lutch C utter
Author(s) -
Komori Keishi,
Akahoshi Kazuya,
Kubokawa Masaru,
Motomura Yasuaki,
Oya Masafumi,
Ihara Eikichi,
Nakamura Kazuhiko
Publication year - 2014
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12643
Subject(s) - medicine , endoscopic submucosal dissection , rectum , perforation , biopsy , surgery , endoscopy , colonoscopy , endoscopic mucosal resection , endoscopic ultrasound , dissection (medical) , radiology , colorectal cancer , cancer , materials science , punching , metallurgy
Abstract Background To reduce the risk of complications related to endoscopic submucosal dissection ( ESD ) using knives, we developed the C lutch C utter ( CC ), which can grasp and incise the target tissue similarly to biopsy techniques using an electrosurgical current. The aim of this study was to evaluate the efficacy and safety of ESD using the CC for removal of rectal carcinoid tumours. Methods Between D ecember 2009 and D ecember 2011, we prospectively enrolled seven patients (seven lesions) on 7 different days. Patients were endoscopically diagnosed with rectal subepithelial lesions (upper rectum, n = 3; lower rectum, n = 4) within the level 3 layer and without lymph node involvement, with the diagnosis confirmed by preliminary endoscopy, endoscopic ultrasound and endoscopic biopsies. ESD using the CC was performed in all cases, and the therapeutic efficacy, safety and tumour recurrence were assessed. Results All lesions were treated easily and safely, and there were no inadvertent incisions. En bloc resection was obtained in all cases, and histologic tumour‐free lateral/basal margins were obtained in six of the seven patients. No delayed haemorrhage, perforation or tumour recurrence occurred. Conclusion ESD using the CC appears to be an easy, safe and technically efficient method for resecting rectal carcinoid tumour.