Use of a multibending scope as a rescue scope in gastric endoscopic submucosal dissection: A retrospective study

Abstract

The aim of this study was to identify factors associated with the use of a multibending scope （MBS） as a rescue instrument in gastric endoscopic submucosal dissection （ESD） for neoplasia. Between January 2015 and June 2023, 502 patients with gastric neoplasia underwent ESD at Showa University Hospital. The patients were classified into ESD with MBS （MB） and ESD with conventional scope only （C） groups. Significantly more cases in the MB group had prolonged procedural times （≥120min）（p＜0.001） and difficult ESD （p＜0.001） compared with the C group. Patients in the MB group had significantly higher rates of lesions located in the lesser curvature （p＜0.001）, larger than 20mm （p＜0.001）, located in the upper two-thirds of the stomach （p＝0.004）, and endoscopic ulceration findings （p＝0.02） compared with the C group. These factors were significant after adjustment in the multivariate analysis. Independent clinicopathological characteristics of superficial gastric neoplasms associated with MBS use as a rescue scope for gastric ESD were identified. These results indicate that using a MBS as the initial scope may be beneficial in certain cases.