| Theme |
Endoscopic treatment of early colorectal cancer and adenoma -- the advancement of EMR and ESD technique |
| Title |
Effectiveness and safety of bipolar current needle knife (B-knife) |
| Author |
Toshio Uraoka |
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences / Division of Endoscopy, National Cancer Center Hospital |
| Author |
Yutaka Saito |
Division of Endoscopy, National Cancer Center Hospital |
| Author |
Takeshi Nakajima |
Division of Endoscopy, National Cancer Center Hospital |
| Author |
Keita Harada |
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences |
| Author |
Jun Kato |
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences |
| Author |
Takahisa Matsuda |
Division of Endoscopy, National Cancer Center Hospital |
| [ Summary ] |
En bloc resections, using endoscopic submucosal dissection (ESD) procedures, provide more accurate histological assessments and reduce local recurrence even of large colorectal lesions. However, ESD is more difficult than conventional endoscopic mucosal resection (EMR). It has a higher incidence of complications, especially perforations, because of the colorectum's bends and thinner walls. Several electronic devices, using monopolar current, have been used for ESD. Here in we introduce a needle knife using bipolar current (B-Knife™, Zeon Medical Inc.) for ESDs of large colorectal tumors, which produced sufficient treatment outcomes. The B-knife has been designed so that high-frequency current sent to the muscle layer is reduced for better control and safer use with the current flowing back from the knife towards the sheath tip.
A retrospective comparable study with a monopolar current electric knife was conducted to assess the clinical effectiveness and safety of the B-knife for ESD of large colorectal tumors 20 ≥ mm. This study showed a higher en bloc resection rate, shorter procedure times, lower rates of associated complications and lower inflammatory reactions, as evidenced by next day blood examinations for C-reactive proteins in the B-knife group. Based on these study results, using the B-knife to perform ESD or large colorectal tumors may be safer and more effective than other electronic devices using monopolar current. |