Superficial gastric neoplasm early gastric cancer, endoscopic summucosal dissection, traction device
Conditions
Interventions
Intervention group
ESD is conducted as following steps: 1) submucosal injection 2)whole circumferential mucosal incision 3)attaching a traction device 4)starting towing 5)submucosal dissection 6)en-bl
endoscopic submucosal dissection, traction device
Sponsors
Takao Toshitatsu
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Subject who are 18 years of age and more 2. Subject who understand and voluntarily sign an informed consent form. 3. Subjects who have superficial gastric neoplasm meeting the absolute or expanded indication for ESD according to the following Japanese guidelines for gastric treatment (6 edition): i) clinically diagnosed intramucosal cancer (cT1a) representing well differentiated-type adenocarcinoma of any size, without ulcerative findings ii) cT1a representing well-differentiated-type adenocarcinoma, less than 30 mm in size, with ulcerative findings iii) cT1a representing undifferentiated-type adenocarcinoma, less than 20 mm in size, without ulcerative findings. 4. Subject who have computed tomography findings without any suspicious lesions of lymph node metastasis and distant metastasis. 5. Subject who have histological findings of group 4 and 5 according to group classification of gastric biopsy. 6. Eastern Cooperative Oncology Group (ECOG) Performance Status: 0-2
Exclusion criteria
Exclusion criteria: 1. Subjects who have lesions which is presumed to be difficult in en-bloc resection without a traction device including lesions estimated having severe fibrosis and lesions located in the esophagogastric junction, the fornix, and on the pylorus ring. 2. Subjects have a history of either gastrectomy or reconstructive surgery of the gastric tract. 3. Subjects have either regidual lesion or local reccurence after previous endoscopic treatment. 4. Subjects were registered to this trial for previous lesion. 5. Subjects who were impossible to comply with the cessation of anticoagulant or antiplatelet medications according to japanese guidelines for gastroenterological endoscopy in patients undergoing antithrombotic treatment and 2017 appendix. 6. Subjects have any hemostasis / coagulation abnormality. 7. Subjects have functional failure in vital organs such as liver, kidney and heart. 8. Subjects were planned to conduct ESD for more than two gastric lesions in the same day. 9. Subjects who are pregnant, suspicious of pregnant and lactating. 10. Subjects who were deemed ineligible for a specific reason.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Procedure time | — |
Secondary
| Measure | Time frame |
|---|---|
| 1) Efficacy-related outcomes (dissecting time, dissection speed, handover rate, en-bloc resection rate, complete en-bloc resection rate, endoscopic curability) 2) Safety-related outcomes (the number of bleeding, adverse events) 3) Device-related outcomes (attachment time, attaching points, the number of devices, the number of slip-off, damage to specimen) | — |
Contacts
Public ContactHirofumi Abe
Kobe university hospital
Outcome results
None listed