Abstract:
Endoscopic submucosal dissection (ESD) is considered curative for patients with early gastrointestinal cancers. However, it is a technically challenging procedure that can be time-consuming and associated with complications such as bleeding and perforation. Traction devices and techniques have been developed to mitigate these risks and reduce procedure times. Most traction devices are unavailable in New Zealand, and traction techniques have not been widely utilized due to the precision required for successful outcomes. We report the first case of traction-assisted ESD performed in New Zealand for a gastric submucosal tumor. The procedure was successfully performed using the clip with rubber band traction technique. The lesion was resected en bloc, and histology confirmed an R0, curative resection. There were no complications, and the total procedure time was 54 minutes. In conclusion, traction techniques can be effectively employed for ESD in lesions with difficult submucosal access. They contribute to safer dissections and reduced procedure times.
摘要:
内镜粘膜下剥离术(ESD)被认为对早期胃肠道癌症患者具有治愈性。然而,这是一项技术上具有挑战性的手术,耗时长,并伴有出血和穿孔等并发症.已经开发了牵引装置和技术来减轻这些风险并减少手术时间。大多数牵引装置在新西兰都没有,由于成功结果所需的精度,牵引技术尚未被广泛使用。我们报告了在新西兰进行的第一例牵引辅助ESD治疗胃粘膜下肿瘤。使用带有橡皮筋牵引技术的夹子成功执行了该程序。病灶全部切除,组织学证实R0,治愈性切除。没有并发症,总手术时间为54分钟。总之,牵引技术可以有效地用于粘膜下通路困难的病变的ESD。它们有助于更安全的解剖和减少手术时间。