https://orcid.org/0000-0001-8294-6673
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Abstract
Introduction
Transanal endoscopic microsurgical submucosal dissection (TEM-ESD) is a technique that has been recently described for the treatment of large rectal adenomas and early rectal cancer. The purpose of our study is to compare TEM-ESD with flexible endoscopic submucosal dissection (ESD) in an experimental, ex vivo porcine model.
Material and methods
We used TEM-ESD and flexible ESD to resect a total of 100 standardized 4 × 4cm lesions in an ex vivo porcine stomach model, performing 50 resections with each technique. Total procedure time, en bloc resection rate, injuries of the muscularis propria, perforation rate and learning curve were analysed.
Results
TEM-ESD was associated with a significantly shorter total procedure time in comparison to ESD (19 min vs. 33 min, p < .001). The rates of en bloc resection, injury of the muscularis propria layer, and perforation were the same in both groups. The learning curve of TEM-ESD was shallower than that of ESD.
Conclusion
TEM-ESD showed an advantage over ESD in terms of procedure time and learning curve, with similar en bloc resection rates and safety profile in our experimental model.
Acknowledgments
The authors would like to thank the companies Karl Storz (Tuttlingen, Germany) for supplying the TEO training platform and instruments and Erbe Elektromedizin (Tuebingen, Germany) for supplying the HybridKnife® I-Type I-Jet and the rigid ERBEJET® applicator and pumps necessary for our experiments.
Ethics approval
Not applicable (no human tissue or live animals used).
Declaration of interest
No potential conflict of interest was reported by the author(s).
Correction Statement
This article has been republished with minor changes. These changes do not impact the academic content of the article.