Korean J Helicobacter Up Gastrointest Res.  2022 Mar;22(1):50-58. 10.7704/kjhugr.2021.0056.

The Efficacy of a Novel Type of Integrated Knife for Endoscopic Submucosal Dissection in Early Gastric Cancer

• Choe EJ
• Jeon HH
• Cho YS
• Won SY
• Seo JH
• Choi JW
• Lee CK
• Park BK
• Lee YK

• KMID: 2527282
• DOI: http://doi.org/10.7704/kjhugr.2021.0056

Abstract

Background/Aims
This study aimed to compare the efficacy of a recently developed clear-cut knife with that of widely used knives for endoscopic submucosal dissection (ESD) in early gastric cancer (EGC).
Materials and Methods
Data were collected retrospectively from the National Health Insurance Service Ilsan Hospital between May 2017 and April 2019. The study included 105 patients (108 lesions) with EGC who underwent ESD. Fifty-six EGCs were dissected using an insulation-tipped diathermic knife in combination with a needle knife, while 52 EGCs were dissected using a clear-cut knife, a single device with an integrated needle and an insulated-tipped knife. Oncologic outcomes and technical success were compared between the two groups.
Results
The distribution of the tumor locations, composition of the undifferentiated types of EGCs, and the size of EGCs (14.3±8.0 vs. 16.6±7.3 mm; P=0.130) were not significantly different between the groups. The complete (98.2% vs. 94.2%; P=0.273) and curative (87.5% vs. 88.5%; P=0.878) resection rates were not statistically different. Furthermore, no significant difference between the total procedure times (39±34.1 vs. 35.7±20.1 minutes; P=0.554), areas of the dissected specimen (858.6±406.5 vs. 980.3±393.8 mm2; P=0.119) and dissected areas per minute (32.4±17.9 vs. 35.5±16.2 mm²/min; P=0.345) were noted. Regarding complications, the overall perforation rates (3.6% vs. 4.0%) and bleeding rates (3.6% vs. 8.0%) were not statistically different.
Conclusions
The newly developed clear-cut knife is as useful as the combination of classical knives for ESD in EGC.

Keyword

Early gastric cancer; Endoscopic knife; Endoscopic submucosal dissection