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CC BY-NC-ND 4.0 · Endosc Int Open 2023; 11(04): E315-E321
DOI: 10.1055/a-1971-1508
Original article

Efficacy of the specialized scissor-type knife for gastric endoscopic submucosal dissection: a propensity score matched retrospective study

Hirosato Tamari
1   Hiroshima University Hospital, Department of Endoscopy, Hiroshima, Japan
,
Shiro Oka
2   Hiroshima University Hospital, Department of Gastroenterology, Hiroshima, Japan
,
Takahiro Kotachi
1   Hiroshima University Hospital, Department of Endoscopy, Hiroshima, Japan
,
Hajime Teshima
2   Hiroshima University Hospital, Department of Gastroenterology, Hiroshima, Japan
,
Junichi Mizuno
2   Hiroshima University Hospital, Department of Gastroenterology, Hiroshima, Japan
,
Motomitsu Fukuhara
2   Hiroshima University Hospital, Department of Gastroenterology, Hiroshima, Japan
,
Hidenori Tanaka
1   Hiroshima University Hospital, Department of Endoscopy, Hiroshima, Japan
,
Akiyoshi Tsuboi
1   Hiroshima University Hospital, Department of Endoscopy, Hiroshima, Japan
,
Ken Yamashita
1   Hiroshima University Hospital, Department of Endoscopy, Hiroshima, Japan
,
Hidehiko Takigawa
1   Hiroshima University Hospital, Department of Endoscopy, Hiroshima, Japan
,
Ryo Yuge
1   Hiroshima University Hospital, Department of Endoscopy, Hiroshima, Japan
,
Yuji Urabe
3   Hiroshima University Hospital, Department of Gastrointestinal Endoscopy and Medicine, Hiroshima, Japan
,
Koji Arihiro
4   University Hospital, Department of Anatomical Pathology, Hiroshima, Japan
,
Shinji Tanaka
1   Hiroshima University Hospital, Department of Endoscopy, Hiroshima, Japan
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Abstract

Background and study aims Prevention of bleeding and perforation during gastric endoscopic submucosal dissection (ESD) is important. Scissor-type knives can accurately grasp and incise the targeted tissue using electrosurgical currents, thereby eliminating unexpected incisions. The SB Knife GX, a scissor-type knife specialized for gastric ESD, was released in June 2016 in Japan. The aim of the present study was to evaluate the efficacy and safety of gastric ESD using the SB Knife GX.

Patients and methods A total of 716 patients who underwent gastric ESD at Hiroshima University Hospital between July 2016 and December 2020 were retrospectively reviewed. From these, 671 patients underwent ESD using the IT Knife 2 (IT-2 group), while 45 underwent ESD using an SB Knife GX (SB-GX group). After propensity score matching, the procedure time, specimen size, en bloc and complete resection rates, and intraoperative bleeding, delayed bleeding, and perforation rates were evaluated.

Results No significant differences were observed in mean procedure time (SB-GX group: 115 ± 165 min; IT-2 group: 95 ± 61 min; P  = 0.82) and en bloc and complete resection rates between the two groups. Intraoperative bleeding rates were significantly lower in the SB-GX group than in the IT-2 group (18 % vs. 40 %; P  = 0.01), and there were no differences in delayed bleeding (4 % vs. 4 %) or perforation (0 % vs. 4 %) between the two groups.

Conclusions The SB Knife GX was proven to be useful for control of intraoperative bleeding during gastric ESD, although the procedure time tended to be longer.

Supplementary material



Publication History

Received: 08 June 2022

Accepted after revision: 25 October 2022

Accepted Manuscript online:
02 November 2022

Article published online:
04 April 2023

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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