Tumor traction techniques in intraluminal endoscopic surgery of the digestive tract
https://doi.org/10.31146/1682-8658-ecg-201-5-110-121
Abstract
Endoscopic submucosal dissection (ESD) is currently an advanced method of treating early cancer of the upper and lower gastrointestinal tract. The ESD allows to remove tumors of any size in an en-bloc, unlike endoscopic mucosal resection (EMR), when we can remove lesions completely only less than 20 mm in size. Despite this advantage, ESD is accompanied by more perforations and bleeding than EMR. Difficult anatomical localization, an unexpressed muscle layer of the organ wall, fibrosis of the submucosal layer and insufficient experience of the operator are the main causes of incomplete resections of the tumor, the development of complications and relapses.
The described methods of tumor traction during submucosal dissection allow increasing the value of en-bloc resection and achieving histologically complete resection. We have presented a wide variety of different methods of tumor traction when performing ESD. We have noted both advantages and disadvantages of traction techniques in endoscopic intraluminal surgery.
About the Authors
A. N. Verbovsky
М. F. Vladimirsky Moscow Regional Research and Clinical Institute
Russian Federation
Russian Federation
Alexander N. Verbovsky, Head of Endoscopy
129110, Moscow, st. Shchepkina, build.61/2, building 1
S. S. Pirogov
P. A. Hertzen Moscow Oncology Research Institute
Russian Federation
Russian Federation
Sergey S. Pirogov, MD, PhD, Head of Endoscopic Department
125284, Moscow, 2nd Botkinsky pr., build. 3
E. S. Vakurova
М. F. Vladimirsky Moscow Regional Research and Clinical Institute
Russian Federation
Russian Federation
Elena S. Vakurova, Head of Endoscopy Department
129110, Moscow, st. Shchepkina, build.61/2, building 1
A. V. Semenkov
М. F. Vladimirsky Moscow Regional Research and Clinical Institute; I. M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Alexey V. Semenkov, MD, PhD, Head of the Department of Oncologic Surgery; professor of the Department of oncology
129110, Moscow, st. Shchepkina, build.61/2, building 1
119991, Moscow, Trubetskaya str., build. 8–2
G. R. Setdikova
М. F. Vladimirsky Moscow Regional Research and Clinical Institute
Russian Federation
Russian Federation
Galiya R. Setdikova, MD, PhD, Head of the Department of Morphological Diagnostics of the Department of Oncology
129110, Moscow, st. Shchepkina, build.61/2, building 1
A. S. Balalykin
М. F. Vladimirsky Moscow Regional Research and Clinical Institute
Russian Federation
Russian Federation
Alexey S. Balalykin, MD, PhD, professor, professor of the Department of Surgery
129110, Moscow, st. Shchepkina, build.61/2, building 1
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Review
For citations:
Verbovsky A.N., Pirogov S.S., Vakurova E.S., Semenkov A.V., Setdikova G.R., Balalykin A.S. Tumor traction techniques in intraluminal endoscopic surgery of the digestive tract. Experimental and Clinical Gastroenterology. 2022;(5):110-121. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-201-5-110-121
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