论文部分内容阅读
Objective Endoscopic submucosal dissection(ESD)has been established as a standard treatment for early stage esophageal cancer globally.In view of the difficulty of esophageal ESD,large numbers of techniques have been developed to overcome the technical difficulties.Several previous researches reported that sthe snare traction may surmount poor visualization of the submucosal layer during ESD.However,there are limited data available about the snare traction for ESD among patients with early esophageal cancers.To evaluate efficacy and safety of auxiliary method using snare traction for ESD among patients with early esophageal cancers.Methods In the snare traction method,a snare affixed to the top of gastroscope,which were followed by application of an appropriate tension to the lesion independent of an endoscope.Twenty random lesions were produced by ESD using snare traction(snare traction group)and compared with a control group,including 20 lesions that were resected by traditional ESD.Randomization was performed according to a computergenerated random sequence with the size and location of the lesion,curvature of the lesion,fibrosis of the lesion and experience of endoscopists.Time of dissection,operating velocity(area/time),non-curative resection rates,and intrinsic muscular injury rates were analyzed.Results Altogether,40 lesions were analyzed in each ESD group(conventional and snare traction).En bloc resection and selfcompletion rates were accomplished among all the lesions by ESD.Compared with the conventional group,time of dissection(34.6 vs.57.1 minutes; P=0.039)was significantly shorter in the snare traction group,operating rates(2.7/5.2 min/cm2,respectively; p<0.01)being obviously shorter in the snare traction group.There were no complications of ESD in the snare traction group,but muscle layer injury bechanced in one patient in the conventional group.Conclusions The Snare traction method shortened procedural time for endoscopes,and have no relation to rates of adverse events.Snare traction method was an effective and safe method for esophageal ESD.