title: Endoscopic submucosal dissection for large colorectal tumors using a cross-counter technique and a novel large-diameter balloon overtube.
abstract: OBJECTIVE
  Endoscopic submucosal dissection (ESD) in early gastric cancer (EGC), which provides a higher complete resection rate than conventional endoscopic mucosal resection (EMR), has rapidly come into widespread use. However, colorectal ESD is not widely used because of its technical difficulty and complications such as perforation, and the procedure time is longer than that of conventional EMR. Development of safer and more reliable devices as well as technique modifications are therefore required. The aim of our study is to compare safety and efficacy of a new traction method, the cross-counter technique, for large colorectal tumors combined with a balloon overtube.
  
  
  METHODS
  A total of 30 patients with large colorectal tumors were analyzed retrospectively; 15 patients for the cross-counter technique group (CC group) and 15 patients for the no-traction group (NT group). Procedure time, complete resection rate, perforation rate and bleeding rate were assessed.
  
  
  RESULTS
  The procedure time was 126 ± 42.2 min and 165 ± 61.3 min in the CC and NT groups, respectively, and there was a significant difference between the two groups (P < 0.05). There were no significant differences in complete resection rate, perforation rate and bleeding rate between the two groups.
  
  
  CONCLUSIONS
  The cross-counter technique shortened the treatment time in colorectal ESD without any complication.
authors.affiliation: Department of Gastroenterology and Oncology, Institute of Health Biosciences, The University of Tokushima, Tokushima, Japan. tagayasu33jp@yahoo.co.jp
authors.forename: Koichi
authors.initials: K
authors.lastname: Okamoto
authors.forename: Naoki
authors.initials: N
authors.lastname: Muguruma
authors.forename: Shinji
authors.initials: S
authors.lastname: Kitamura
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Kimura
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Takayama
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D004210:Dissection / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies