Randomized Controlled Trial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2015; 21(26): 8195-8202
Published online Jul 14, 2015. doi: 10.3748/wjg.v21.i26.8195
Safety and efficacy of carbon dioxide insufflation during gastric endoscopic submucosal dissection
Jun Takada, Hiroshi Araki, Fumito Onogi, Takayuki Nakanishi, Masaya Kubota, Takashi Ibuka, Masahito Shimizu, Hisataka Moriwaki
Jun Takada, Hiroshi Araki, Fumito Onogi, Takayuki Nakanishi, Masaya Kubota, Takashi Ibuka, Masahito Shimizu, Hisataka Moriwaki, Department of Gastroenterology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan
Author contributions: Takada J and Araki H contributed to the study design, acquisition and interpretation of data, and in the writing of the manuscript; Onogi F and Nakanishi T acquired the data; Kubota M and Ibuka T analyzed and interpreted the data; Shimizu M wrote the manuscript; and Moriwaki H approved the final contents of the manuscript.
Institutional review board statement: The study was reviewed and approved by the ethics committee for clinical research at Gifu University Hospital.
Clinical trial registration statement: This study is not registered.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: The technical appendix, statistical code, and dataset are available from the corresponding author at araara@gifu-u.ac.jp. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hiroshi Araki, MD, PhD, Assistant Professor, Department of Gastroenterology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 5011194, Japan. araara@gifu-u.ac.jp
Telephone: +81-58-2306308 Fax: +81-58-2306310
Received: December 12, 2014
Peer-review started: December 16, 2014
First decision: January 22, 2015
Revised: February 13, 2015
Accepted: March 18, 2015
Article in press: March 19, 2015
Published online: July 14, 2015
Processing time: 214 Days and 9.9 Hours
Core Tip

Core tip: The safety and efficacy of carbon dioxide (CO2) and air insufflation during gastric endoscopic submucosal dissection (ESD) were compared in a randomized controlled trial. The transcutaneous CO2 tension and the partial pressure of CO2 in the arterial blood were measured to directly evaluate CO2 retention or acidemia. The findings strongly suggest that CO2 insufflation is as safe as air insufflation with regard to blood gas levels. The present study is the first randomized controlled trial to demonstrate the benefit of CO2 insufflation in reducing the risk of Mallory-Weiss tears during ESD.