“SRING-TO-RING” TRACTION TECHNIQUE FOR ESD – THE FIRST EXPERIENCE

Aims:

Improving the results of Endoscopic Submucosal Dissection using “string-to-ring” traction technique.

Methods:

Between October 2016 and September 2017, 20 cases ESDs of the malignant lesions larger than 3 cm in the rectum were performed. The patients were divided into two groups (“string-to-ring” ESD, n = 12; conventional ESD, n = 8). The “string-to-ring” method is to create traction using a thread fixed to the edge of the tumor that is moved through a ring located on the clip on the opposite wall. The results for “string-to-ring” ESD and conventional ESD were compared. Time of the procedure, the frequency of complications and curative resection numbers were evaluated.

Results:

Advantage of the method is its simplicity, the ability to change the force of tension, as well as the angle of traction of the tumor being removed, the most convenient access to the submucosa is achieved. Analyzing the obtained data, the “string-to-ring” method allowed to shorten the operation time, reduce the number of intraoperative bleeding and perforations.

Conclusions:

ESD “string-to-ring” traction technique – a promising technique with potential for clinical application. This method facilitates ESD, reduces procedure timing, the number of such intraoperative complications like bleeding and perforation.