Abstract
As a new technique of ESD for the colorectal neoplasm, we contrive and enforce the “Three-channeled scope method”. In this study, we compared it with the conventional ESD method from the view of the usability and the problem. This technique is one kind of “counter-traction method”. Two-channeled colonoscope, added the third channel outside the scope for the grasping forceps, is used for this purpose. Through these channels, we can use some type of devices to enforce the operations, to say, local injection, lifting up and dissection of the tumor.
Out of 260 cases of colorectal ESD which we have performed, 46 cases of Three-channeled scope method and 79 cases of conventional method are compared in the view of removal major diameter, removing time, dissecting time and complications. At the removal major diameter, there is not a significant difference in both methods. Meanwhile, the average removing time is 31.0 minutes in 51.7 minutes, the Three-channeled method in the conventional one. Identically, in the average dissecting time, the former is better than the latter, by 19.4 minutes vs. 34.6 minutes. No perforation is seen in the cases of Three-channeled method, nor hemorrhage with a blood transfusion.
In future, the development of new cutting devices, maneuverable scopes, 3-D displays and the robot operation and so on are thought of.
It judged that this technique is very useful in performing the colorectal ESD more safely and rapidly.
