EMR + with the AWC improves endoscopic resection speed compared to ESD: a porcine ex-vivo pilot study.

To improve resection speed and to reach higher en bloc resection rates in lesions ≥ 2 cm, a novel grasp and snare EMR technique termed "EMR+", accomplished by an additional working channel (AWC), was developed. Its use compared to endoscopic submucosal dissection (ESD) is evaluated for the first time. We prospectively conducted a randomized pre-clinical ex-vivo pilot study in explanted porcine stomachs for the comparison of EMR + with classical ESD of mucosal-based lesions. Prior to intervention, we set flat lesions with a standardized size of 3 × 3 cm. The median time of procedure was significantly shorter in the EMR + group (median 10.5 min, range 4.4-24 min) than in the ESD group (median 32 min, range 14-61.6 min, p < .0001). The rate of en bloc resection was significantly lower in the EMR + group (38 % vs. 95 %) (p < .0001). Nevertheless, an improvement in the learning curve for EMR + was achieved after the first 12 procedures, with a subsequent en bloc resection rate of 100 %. EMR + could improve the efficiency of mucosal resection procedures. Initial experience demonstrates a higher and satisfactory en bloc resection rate after going through the learning curve of EMR+.

Citation

Edris Wedi, Richard Knoop, Carlo Jung, Mark Gromski, Chi Nghia Ho, Gabor Conrad, Juergen Maiss, Sinisa Milenovic, David Klemme, Ulrich Baulain, Ali Seif Amir Hosseini, Volker Ellenrieder, Peter Koehler. EMR + with the AWC improves endoscopic resection speed compared to ESD: a porcine ex-vivo pilot study. Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy. 2021 Feb;30(1):47-54

Mesh Tags

PMID: 31597491

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