Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 7, 2017; 23(29): 5422-5430
Published online Aug 7, 2017. doi: 10.3748/wjg.v23.i29.5422
Efficacy of forced coagulation with low high-frequency power setting during endoscopic submucosal dissection
Tsukasa Ishida, Takashi Toyonaga, Yoshiko Ohara, Tadao Nakashige, Yasuaki Kitamura, Ryusuke Ariyoshi, Hiroshi Takihara, Shinichi Baba, Tetsuya Yoshizaki, Fumiaki Kawara, Shinwa Tanaka, Yoshinori Morita, Eiji Umegaki, Namiko Hoshi, Takeshi Azuma
Tsukasa Ishida, Yoshiko Ohara, Yasuaki Kitamura, Ryusuke Ariyoshi, Tetsuya Yoshizaki, Fumiaki Kawara, Shinwa Tanaka, Yoshinori Morita, Eiji Umegaki, Namiko Hoshi, Takeshi Azuma, Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe 650-0017, Japan
Takashi Toyonaga, Department of Endoscopy, Kobe University Hospital, Kobe 650-0017, Japan
Takashi Toyonaga, Tadao Nakashige, Hiroshi Takihara, Shinichi Baba, Department of Endoscopy, Kishiwada Tokushukai Hospital, Osaka 596-0042, Japan
Author contributions: Ishida T, Toyonaga T and Ohara Y designed the study; Kitamura Y, Ariyoshi R, Takihara H, Baba S, Yoshizaki T, Kawara F and Tanaka S participated in the acquisition, analysis, and interpretation of the data; Ishida T wrote the manuscript; Ohara Y and Hoshi N revised the article and suggested the comments; Morita Y, Umegaki E and Azuma T supervised the report.
Institutional review board statement: This study was reviewed and approved by both the ethics committees of Kobe University Hospital and Kishiwada Tokushukai Hospital.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: Toyonaga T invented the FlushKnife-BT in conjunction with Fujifilm and received royalties from its sale; Ishida T, Ohara Y, Nakashige T, Kitamura Y, Ariyoshi R, Takihara H, Baba S, Yoshizaki T, Kawara F, Tanaka S, Morita Y, Umegaki E, Hoshi N, and Azuma T have no conflicts of interest or financial ties to disclose.
Data sharing statement: No additional data are available.
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: Takashi Toyonaga, MD, PhD, Department of Endoscopy, Kobe University Hospital, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. toyonaga@med.kobe-u.ac.jp
Telephone: +81-78-3825774 Fax: +81-78-3826309
Received: January 27, 2017
Peer-review started: February 4, 2017
First decision: March 16, 2017
Revised: March 31, 2017
Accepted: June 19, 2017
Article in press: June 19, 2017
Published online: August 7, 2017
Processing time: 192 Days and 1.1 Hours
Core Tip

Core tip: The prevention of bleeding during endoscopic submucosal dissection (ESD) is one of the most important factors in safe and successful tumor removal. We investigated the difference in bleeding rates between S method and F1-10 method in stomach ESD. The investigation suggests that F1-10 method can achieve a stronger hemostatic effect than S method for large vessels. In addition, we investigated the difference of the hemostatic strength and mechanism using ex vivo model. F1-10 method could sustain electrical current longer and effectively coagulate wider and deeper areas of tissue than S method, resulting in a strong hemostatic effect.