Brief Article
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World J Gastroenterol. Oct 7, 2013; 19(37): 6221-6227
Published online Oct 7, 2013. doi: 10.3748/wjg.v19.i37.6221
Grasper type scissors for endoscopic submucosal dissection of gastric epithelial neoplasia
Woo-Chul Chung, Byung-Wook Kim, Chul-Hyun Lim, Tae-Ho Kim, Jae-Myung Park, Joon-Sung Kim
Woo-Chul Chung, Division of Gastroenterology, Department of Internal Medicine, Suwon St. Vincent’s Hospital, The Catholic University of Korea, Suwon 441-400, South Korea
Byung-Wook Kim, Joon-Sung Kim, Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon 421-735, South Korea
Chul-Hyun Lim, Jae-Myung Park, Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul 136-701, South Korea
Tae-Ho Kim, Division of Gastroenterology, Department of Internal Medicine, Bucheon St. Mary’s Hospital, The Catholic University of Korea, Bucheon 398-213, South Korea
Author contributions: Chung WC, Lim CH, Kim BW and Kim TH contributed to the acquisition of data; Chung WC wrote the manuscript; Kim BW contributed to design the study; Park JM and Kim JS supervised the study and helped in data analysis.
Supported by Research grants from Korean Society of Gastrointestinal Endoscopy
Correspondence to: Byung-Wook Kim, MD, PhD, Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, 56 Dongsu-Ro, Bupyeong-gu, Incheon 403-720, South Korea. gastro@catholic.ac.kr
Telephone: +82-32-2805052 Fax: +82-32-2805987
Received: May 7, 2013
Revised: July 1, 2013
Accepted: August 12, 2013
Published online: October 7, 2013
Abstract

AIM: To evaluate the efficacy and safety of grasper type scissors (GTS) for endoscopic submucosal dissection (ESD) of gastric epithelial neoplasia.

METHODS: The study was performed by 4 endoscopists in 4 institutions affiliated to The Catholic University of Korea. ESD was performed in 76 consecutive patients with gastric epithelial neoplasia by using the GTS (37 patients) or the hook knife plus coagrasper (HKC) (39 patients). The complete resection rate, complication rate, total time elapsed and elapsed time per square centimeter of the dissected specimen were analyzed between the GTS and HKC group.

RESULTS: The mean age of the GTS group was 62.3 ± 11.4 years and mean age of the HKC group was 65.6 ± 10.1 years. Differentiated adenocarcinoma was found in 32.4% in the GTS group and 33.3% in the HKC group. The procedures were performed without interruption in every case in both groups. The en bloc resection rates of both groups were 100%. The total time elapsed during the procedure was 44.54 ± 21.72 min in the GTS group and 43.77 ± 21.84 min in the HKC group (P = 0.88) and the time elapsed per square centimeter of the resected lesion was 7.53 ± 6.35 min/cm2 in the GTS group and 6.92 ± 5.93 min/cm2 in the HKC group (P = 0.66). The overall complication rate was not significantly different between the two groups.

CONCLUSION: GTS is a safe and effective device for ESD compared with HKC. ESD can be performed with GTS alone, which can reduce the costs for ESD.

Keywords: Gastric epithelial neoplasia, Endoscopic submucosal dissection, Grasper type scissors, Hook knife, Coagrasper

Core tip: Many types of knives have been developed and used for endoscopic submucosal dissection (ESD). We modified the grasping type scissors forceps and developed a novel grasper type scissors (GTS). The aim of this study was to evaluate the efficacy and safety of GTS compared to hook knife plus coagrasper (HKC) for ESD of gastric epithelial neoplasia. The procedures were performed without interruption in every case in both groups. GTS is a safe and effective device for ESD of gastric epithelial neoplasia compared with HKC. ESD can be performed with GTS alone, which can reduce the costs for ESD.