Orthodontic Rubber Band-Assisted Endoscopic Submucosal Dissection: An Efficient Method for Treating Superficial Colorectal Tumors

Linfu Zheng; Wen Wang; Dazhou Li; Junguo Chen; Longping Chen; Rong Wang; Chuanshen Jiang; Guanpo Zhang; Yaping Hou; Jin Zheng; Yang Bai

doi:10.1155/2022/2835258

Orthodontic Rubber Band-Assisted Endoscopic Submucosal Dissection: An Efficient Method for Treating Superficial Colorectal Tumors

Gastroenterol Res Pract. 2022 Jan 30:2022:2835258. doi: 10.1155/2022/2835258. eCollection 2022.

Authors

Linfu Zheng^#^{1

2

3}, Wen Wang^#^{2

3

4}, Dazhou Li^{2

3

4}, Junguo Chen², Longping Chen^{2

3}, Rong Wang^{2

3

4}, Chuanshen Jiang^{2

3}, Guanpo Zhang^{2

3}, Yaping Hou⁴, Jin Zheng⁴, Yang Bai¹

Affiliations

¹ Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Institute of Gastroenterology of Guangdong Province, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
² Department of Gastroenterology, Fuzhou General Clinical Medical College of Fujian Medical University, Fuzhou 350025, China.
³ Department of Gastroenterology, 900th Hospital of People's Liberation Army, Fuzhou 350025, China.
⁴ Department of Gastroenterology, Oriental Hospital Affiliated to Xiamen University, Fuzhou 350025, China.

^# Contributed equally.

Abstract

Background: Colorectal endoscopic submucosal dissection (ESD) is a complex operation. Effective traction is crucial. We have successfully used an orthodontic rubber band (ORB) combined with the clip traction method to assist ESD (ORB-ESD). The aim of this retrospective study is to describe the method and to compare the efficacy and safety of ORB-ESD versus conventional ESD in the treatment of superficial colorectal tumors.

Methods: We retrospectively analyzed the data of patients with superficial colorectal tumor (with diameter ≥ 20 mm) who received either ORB-ESD (n = 34) or conventional ESD (n = 90) between January 2019 and September 2020. Propensity score matching (PSM) was used to match the clinical data of 31 pairs of patients in each group.

Results: Operation time was significantly shorter for ORB-ESD than for conventional ESD (34.5 minutes vs. 56 minutes, P ≤ 0.001). In the propensity-matched cohorts, the operation time remained significantly shorter in the ORB-ESD patients (35 minutes vs. 50 minutes, P = 0.001). Postoperative adverse events, en bloc resection rate, and R0 resection rate were comparable between the two groups (P > 0.05), both before and after propensity score matching. In the ORB subgroup analysis, the trainee and expert ESD operation times were similar (37 (26-53) vs. 33.5 (26-37) minutes, respectively; P = 0.274).

Conclusion: ORB-ESD appears to be an effective technique for ESD of colorectal cancer. Our findings need to be confirmed in large prospective multicenter studies.