Comparisons of outcomes between ProKnife injection endoscopic submucosal dissection and conventional endoscopic submucosal dissection for large gastric lesions in ex vivo porcine model study: A randomized controlled trial. Issue 1 (26th January 2022)

• Record Type: Journal Article
• Authors: Esaki, Mitsuru; Ihara, Eikichi; Esaki, Misato; Nishioka, Kei; Kimura, Yusuke; Hata, Yoshitaka; Tsuru, Hirotaka; Wada, Masafumi; Minoda, Yosuke; Bai, Xiaopeng; Shoguchi, Yoshihisa; Nasu, Takayuki; Nagatomo, Shuzaburo; Muta, Kazumasa; Ogino, Haruei; Ogawa, Yoshihiro
• Is Part Of: DEN open. Volume 2:Issue 1(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-01-26
• Subjects: endoscopic submucosal dissection -- ex vivo porcine model -- gastric lesions -- predictive factors -- ProKnife; Gastrointestinal system -- Diseases -- Endoscopic surgery -- Periodicals; Gastroenterology -- Periodicals; 616.3307545
• DOI: 10.1002/deo2.91
• Languages: English
• ISSNs: 2692-4609

Abstract

Abstract: Objective: To compare treatment outcomes between injection endoscopic submucosal dissection using ProKnife (P‐ESD) and conventional ESD (C‐ESD) for gastric lesions. Methods: In this randomized controlled trial, we compared treatment outcomes of P‐ESD and C‐ESD for simulated gastric lesions ≥3 cm in resected porcine stomachs. Predictive factors associated with ESD difficulties were investigated using logistic regression analysis. Results: Seventy lesions were screened; however, two lesions were excluded. A total of 12 endoscopists performed 68 ESDs: 34 P‐ESDs and 34 C‐ESDs. The ESD procedure time of P‐ESD (36.3 [28.4–46.8] min) was significantly shorter than that of C‐ESD (46 [36.4–64.6] min; p = 0.0014). The technical success rates did not differ between the P‐ESD and C‐ESD groups (en bloc resection rate, 100% in both groups; complete resection rate, 94.1% and 85.3%, respectively; p = 0.23). The number of injections during P‐ESD (7.5 [6–10] times) was significantly higher than during C‐ESD (4 [3–5] times; p < 0.001), but the total volume of injected solution during P‐ESD (20 [16–26.3] ml) was significantly smaller than during C‐ESD (27.5 [20–31.5] ml; p = 0.0019). In multivariate analysis, less ESD experience (odds ratio [OR], 3.9) and selection of C‐ESD as the ESD method (OR, 3.8) were independent predictive factors associated with ESD difficulties. Conclusions: Compared with C‐ESD, P‐ESD had a shorter procedure time but also allowed for notable technical success and safety.