А.A. Mitrakov1,2, K.S. Prikhodko2, N.I. Khabazov2, V.A. Kryazhov1,2
1Nizhniy Novgorod Regional Clinical Cancer Center, Nizhniy Novgorod
2Volga Region Research Medical University, Nizhniy Novgorod
Mitrakov A.A. ― Head of the Endoscopic Department of Nizhniy Novgorod Regional Clinical Cancer Center
11/1 Delovaya Str., Nizhny Novgorod, Russian Federation, tel. +7-930-700-33-84, e-mail: alexandr_mit@mail.ru
Abstract. The results for «String-to-ring» ESD and conventional ESD were compared. 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. 32 cases ESDs of the malignant lesions larger than 3 cm in the rectum were performed between October 2016 and May 2018. The patients were divided into two groups («String-to-ring» ESD, n=12; conventional ESD, n=20). Time of the procedure, the frequency of complications and curative resection numbers were evaluated.
Analyzing the obtained data, the «String-to-ring» method allowed to shorten the operation time (50/70 min), reduce the number of intraoperative bleeding and perforations (0/2), increase the number of curative resections.
At the conclusion, ESD «String-to-ring» traction technique ― a promising technique with potential for clinical application. «String-to ring» is the simple technique. The advantage of this method is the simplification in visualizing the submucosal layer due to the direction of gravity. This method facilitates ESD, reduces procedure timing, the number of such intraoperative complications like bleeding and perforation.
Key words: ESD, endoscopic dissection in the submucosal layer, endoscopy, rectal neoplasms, endoscopic traction, string-to-ring.