Copyright
©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jul 16, 2017; 9(7): 334-340
Published online Jul 16, 2017. doi: 10.4253/wjge.v9.i7.334
Endoscopic submucosal dissection of gastric adenomas using the clutch cutter
Kazuya Akahoshi, Masaru Kubokawa, Junya Gibo, Shigeki Osada, Kayo Tokumaru, Eriko Yamaguchi, Hiroko Ikeda, Takao Sato, Kazuaki Miyamoto, Yusuke Kimura, Yuki Shiratsuchi, Kazuaki Akahoshi, Masafumi Oya, Hidenobu Koga, Eikichi Ihara, Kazuhiko Nakamura
Kazuya Akahoshi, Masaru Kubokawa, Junya Gibo, Shigeki Osada, Kayo Tokumaru, Eriko Yamaguchi, Hiroko Ikeda, Takao Sato, Kazuaki Miyamoto, Yusuke Kimura, Yuki Shiratsuchi, Kazuaki Akahoshi, Department of Gastroenterology, Aso Iizuka Hospital, Iizuka 820-8505, Japan
Masafumi Oya, Department of Pathology, Aso Iizuka Hospital, Iizuka 820-8505, Japan
Hidenobu Koga, Clinical Research Support Office, Aso Iizuka Hospital, Iizuka 820-8505, Japan
Eikichi Ihara, Kazuhiko Nakamura, Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
Author contributions: Akahoshi K designed the study; Akahoshi K, Kubokawa M, Gibo J, Osada S, Tokumaru K, Yamaguchi E, Ikeda H, Sato T, Miyamoto K, Kimura Y, Shiratsuchi Y, Akahoshi K and Oya M performed the research; Koga H analyzed the data; Akahoshi K wrote the paper; Ihara E and Nakamura K revised the manuscript for final submission.
Institutional review board statement: This study was approved by the Institutional Review Board of Aso Iizuka Hospital.
Clinical trial registration statement: UMIN000009679.
Informed consent statement: Written informed consent for the procedures and treatment was obtained from patients.
Conflict-of-interest statement: Kazuya Akahoshi and Hidefumi Akahane (FUJIFILM) have applied for the patent in Europe for the Clutch Cutter described in this article. Japan, China, and the United states have already granted the patent. The authors claim no other conflicts of interest.
Data sharing statement: Informed consent was not obtained for data sharing, and 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: Kazuya Akahoshi, MD, PhD, Department of Gastroenterology, Aso Iizuka Hospital, 3-83 Yoshio, Iizuka 820-8505, Japan.
kakahoshi2@aol.com
Telephone: +81-948-223800 Fax: +81-948-298747
Received: October 28, 2016
Peer-review started: November 2, 2016
First decision: December 1, 2016
Revised: January 20, 2017
Accepted: March 23, 2017
Article in press: March 24, 2017
Published online: July 16, 2017
Processing time: 249 Days and 9.9 Hours
AIM
To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) using the clutch cutter (CC) (ESD-CC) for gastric adenoma (GA).
METHODS
From June 2007 to August 2015, 122 consecutive patients with histological diagnoses of GA from specimens resected by ESD-CC were enrolled in this prospective study. The CC was used for all ESD steps (marking, mucosal incision, submucosal dissection, and hemostatic treatment), and its therapeutic efficacy and safety were assessed.
RESULTS
Both the en-bloc resection rate and the R0 resection rate were 100% (122/122). The mean surgical time was 77.4 min, but the time varied significantly according to tumor size and location. No patients suffered perforation. Post-ESD-CC bleeding occurred in six cases (4.9%) that were successfully resolved by endoscopic hemostatic treatment.
CONCLUSION
ESD-CC is a technically efficient, safe, and easy method for resecting GA.
Core tip: The clutch cutter (CC) was developed to reduce risk of complications related to endoscopic submucosal dissection (ESD) using conventional knives. The CC can grasp, pull, coagulate and/or incise targeted tissue using electrosurgical current, as with a bite biopsy. The CC can be used in all ESD steps (marking, mucosal incision, submucosal dissection, and hemostatic treatment). ESD using the CC (ESD-CC) for gastric adenoma (GA) gave a 100% R0 resection rate in this study, with no perforation. ESD-CC is a technically efficient, safe, and easy method for resecting GA.
