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Risk of lens cloudiness during colorectal endoscopic submucosal dissection and ability of a novel lens cleaner to maintain and restore endoscopic view
Author(s) -
Yoshida Naohisa,
Naito Yuji,
Hirose Ryohei,
Ogiso Kiyoshi,
Siah Kewin Tien Ho,
Inada Yutaka,
Dohi Osamu,
Kamada Kazuhiro,
Katada Kazuhiro,
Uchiyama Kazuhiko,
Handa Osamu,
Takagi Tomohisa,
Konishi Hideyuki,
Yagi Nobuaki,
Itoh Yoshito
Publication year - 2015
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12442
Subject(s) - lens (geology) , cloud cover , medicine , surgery , cloud computing , optics , computer science , physics , operating system
Background and Aim Generally, colorectal endoscopic submucosal dissection ( ESD ) cannot be carried out with severe lens cloudiness. We examined the occurrence of lens cloudiness during ESD as well as the efficacy of a novel cleaner for it. Methods This study was a prospective study compared to historical control. First, we analyzed 103 ESD cases using standard cleaner at the K yoto P refectural U niversity of M edicine in 2012. Relationship between lens cloudiness and clinical characteristics of lesions was analyzed. Lens cloudiness was recorded as grade 0 (clear) to grade 2 (very unclear). Then, we recruited 92 consecutive patients who underwent colorectal ESD using the novel cleaner from A ugust 2013 to J uly 2014. The cleaner was applied on top of the lens before procedure and ability to prevent lens cloudiness was tested. Additionally, the novel cleaner was injected from endoscopic channel into a space created by endoscopic hood and colonic wall in seven cases with grade 1 or 2 of lens cloudiness and the ability to clean lens cloudiness inside the colon was tested. Results Rate of severe lens cloudiness was 8.7%. Multivariate analysis showed that severe lens cloudiness was related with severe submucosal fatty tissue ( P < 0.001). The novel cleaner had significantly less cloudiness cases compared to the standard cleaner (14.1% vs 33.0%, P = 0.002). Additionally, the novel cleaner enabled us to clean lens cloudiness in all seven cases. Conclusion Lens cloudiness during ESD was associated with submucosal fatty tissue. Effective lens cleaner should be used to prevent and clean lens cloudiness.