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Usefulness of the S-O clip for duodenal endoscopic submucosal dissection: a propensity score-matched study
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Ippei Tanaka, Dai Hirasawa, Hiroaki Saito, Junichi Akahira, Tomoki Matsuda
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Clin Endosc 2023;56(6):769-777. Published online May 24, 2023
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DOI: https://doi.org/10.5946/ce.2022.195
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 Graphical Abstract
 Abstract
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 - Background
/Aims: Endoscopic submucosal dissection (ESD) for superficial non-ampullary duodenal tumors (SNADETs) is associated with a high rate of en bloc resection. However, the technique for ESD remains challenging. Recent studies have demonstrated the effectiveness of S-O clips in colonic and gastric ESD. We evaluated the efficacy and safety of duodenal ESD using an S-O clip for SNADETs.
Methods
Consecutive patients who underwent ESD for SNADETs between January 2011 and December 2021 were retrospectively enrolled. Propensity score matching analysis was used to compare patients who underwent duodenal ESD with the S-O clip (S-O group) and those who underwent conventional ESD (control group). Intraoperative perforation rate was the primary outcome, while procedure time and R0 resection rate were the secondary outcomes.
Results
After propensity score matching, 16 pairs were created: 43 and 17 in the S-O and control groups, respectively. The intraoperative perforation rate in the S-O group was significantly lower than that in the control group (p=0.033). A significant difference was observed in the procedure time between the S-O and control groups (39±9 vs. 82±30 minutes, respectively; p=0.003).
Conclusions
The S-O clip reduced the intraoperative perforation rate and procedure time, which may be useful and effective in duodenal ESD.
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Citations
Citations to this article as recorded by  - A method of “Noninjecting Resection using Bipolar Soft coagulation mode; NIRBS” for superficial non-ampullary duodenal epithelial tumor: a pilot study
Mitsuo Tokuhara, Yasushi Sano, Yoshifumi Watanabe, Hidetoshi Nakata, Hiroko Nakahira, Shingo Furukawa, Takuya Ohtsu, Naohiro Nakamura, Takashi Ito, Ikuko Torii, Takeshi Yamashina, Masaaki Shimatani, Makoto Naganuma
BMC Gastroenterology.2024;[Epub] CrossRef - Traction methods for endoscopic submucosal dissection
Ji Hyun Kim, Sung Chul Park
Journal of Innovative Medical Technology.2024; 2(2): 47. CrossRef
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Factors influencing lateral margin diagnosis challenges in Barrett’s esophageal cancer: a bicenter retrospective study in Japan
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Ippei Tanaka, Shuhei Unno, Kazuki Yamamoto, Yoshitaka Nawata, Kimihiro Igarashi, Tomoki Matsuda, Dai Hirasawa
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Received March 28, 2024 Accepted June 4, 2024 Published online November 11, 2024
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DOI: https://doi.org/10.5946/ce.2024.068
[Epub ahead of print]
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Graphical Abstract
Abstract
PDFPubReaderePub
 - Background
/Aims: We aimed to clarify the clinicopathological characteristics and causes of Barrett’s esophageal adenocarcinoma (BEA) with unclear demarcation.
Methods
We reviewed BEA cases between January 2010 and August 2022. The lesions were classified into the following two groups: clear demarcation (CD group) and unclear demarcation (UD group). We compared the clinicopathological findings between the two groups. Furthermore, we measured the length and width of the foveolar structures, as well as the width of marginal crypt epithelium (MCE).
Results
We analyzed data from 68 patients with BEA, including 47 and 21 in the CD and UD groups, respectively. Multivariate analysis revealed long-segment Barrett’s esophagus (LSBE) as the sole significant risk factor for BEA (odds ratio, 12.17; 95% confidence interval, 2.84–47.6; p=0.001). Regarding pathological analysis, significant differences were observed in the length and width of the foveolar structure between cancerous and surrounding mucosa in the CD group (p=0.03 and p=0.00, respectively); however, no significant difference was observed in the UD group (p=0.53 and p=0.72, respectively). Nevertheless, the width of MCE in the cancerous area was significantly shorter than that in the surrounding mucosa in both groups (p<0.05, and p<0.05, respectively).
Conclusions
LSBE is a significant risk factor for BEA in the UD group. The width of MCE may be an important factor in the endoscopic diagnosis of BEA.
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