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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jun 27, 2021; 13(6): 563-573
Published online Jun 27, 2021. doi: 10.4240/wjgs.v13.i6.563
Efficacy of hybrid endoscopic submucosal dissection with SOUTEN in gastric lesions: An ex vivo porcine model basic study
Mitsuru Esaki, Eikichi Ihara, Norikazu Hashimoto, Shuichi Abe, Chihoko Aratono, Noriko Shiga, Yorinobu Sumida, Hiroyuki Fujii, Kazuhiro Haraguchi, Shunsuke Takahashi, Tsutomu Iwasa, Kayoko Nakano, Masafumi Wada, Shinichi Somada, Kei Nishioka, Yosuke Minoda, Haruei Ogino, Yoshihiro Ogawa
Mitsuru Esaki, Eikichi Ihara, Masafumi Wada, Kei Nishioka, Yosuke Minoda, Haruei Ogino, Yoshihiro Ogawa, Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
Eikichi Ihara, Department of Gastroenterology and Metabolism, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
Norikazu Hashimoto, Shunsuke Takahashi, Department of Gastroenterology, Fukuoka City Hospital, Fukuoka 811-1394, Japan
Shuichi Abe, Kazuhiro Haraguchi, Department of Gastroenterology, Harasanshin Hospital, Fukuoka 812-0033, Japan
Chihoko Aratono, Hiroyuki Fujii, Department of Gastroenterology and Hepatology, National Hospital Organization Fukuokahigashi Medical Center, Koga 811-3195, Japan
Noriko Shiga, Tsutomu Iwasa, Department of Gastroenterology, Fukuokaken Saiseikai Futsukaichi Hospital, Futsukaichi 811-8516, Fukuoka, Japan
Yorinobu Sumida, Department of Gastroenterology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka 810-8564, Japan
Kayoko Nakano, Department of Gastroenterology, Fukuoka Central Hospital, Fukuoka 805-0050, Japan
Shinichi Somada, Department of Gastroenterology, National Hospital Organization Beppu Medical Center, Beppu 874-0011, Japan
Author contributions: Esaki M, Ihara E, Hashimoto N, Wada M, and Minoda Y designed the research; Esaki M drafted the article; Fujii H, Haraguchi K, Takahashi S, Iwasa T, Nakano K, Ogino H, and Ogawa Y revised article for important intellectual content; All authors approved the final version of the article.
Conflict-of-interest statement: Eikichi Ihara participated in the funded research of Takeda Pharmaceutical Co., Ltd. and belongs to the endowed course supported by the companies mentioned, including Ono Pharmaceutical Co., Ltd., Miyarisan Pharmaceutical Co. Ltd., Sanwa Kagaku Kenkyusho Co., Ltd., Otsuka Pharmaceutical Factory, Inc., Fujifilm Medical Co., Ltd., Termo Corporation, Fancl Corporation, and Ohga Pharmacy. Eikichi Ihara received a lecture fee from Takeda Pharmaceutical Co. Yoshihiro Ogawa is conducting a joint study with Fancl Corporation and Fujifilm Medical Co., Ltd. Other authors have no conflicts of interest or financial ties to disclose.
Data sharing statement: Technical appendix, statistical code, and dataset are available from the corresponding author.
ARRIVE guidelines statement: The authors have read the ARRIVE guidelines, and the manuscript was prepared and revised according to the ARRIVE guidelines.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/ Corresponding author: Eikichi Ihara, MD, PhD, Associate Professor, Department of Gastroenterology and Metabolism, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
eikichi@intmed3.med.kyushu-u.ac.jp
Received: February 9, 2021
Peer-review started: February 9, 2021
First decision: May 4, 2021
Revised: May 7, 2021
Accepted: June 16, 2021
Article in press: June 16, 2021
Published online: June 27, 2021
Processing time: 129 Days and 4.2 Hours
ARTICLE HIGHLIGHTS
Research background
Hybrid endoscopic submucosal dissection (ESD) has been developed as an advanced technique combining conventional ESD and endoscopic mucosal resection procedures. A multifunctional device called SOUTEN has been invented for hybrid ESD procedures.
Research motivation
It is unclear whether hybrid ESD using SOUTEN is superior to conventional ESD for gastric lesions.
Research objectives
This study aimed to determine whether and how hybrid ESD is superior to conventional ESD in the endoscopic treatment of gastric lesions in an ex vivo porcine model basic study.
Research methods
A total of 32 ESD on mock lesions in an ex vivo porcine stomach model were performed using SOUTEN; 16 hybrid ESD and 16 conventional ESD. Technical outcomes were compared between the two groups.
Research results
Hybrid ESD achieved significantly shorter procedure time than conventional ESD, with favorable curability, and a low complication rate. The selection of conventional ESD as the treatment method was significantly associated with the difficulties during ESD on multivariate analysis.
Research conclusions
Hybrid ESD with SOUTEN improves the technical outcomes of ESD for gastric lesions.
Research perspectives
A randomized controlled trial in humans is expected to be conducted to confirm that hybrid ESD using SOUTEN is superior to the conventional ESD in the future.
