title: Percutaneous transgastric traction-assisted esophageal endoscopic submucosal dissection: a randomized controlled trial in a porcine model.
abstract: OBJECTIVE
  Endoscopic submucosal dissection (ESD) is a technically difficult, hazardous, and time-consuming treatment option for superficial neoplasms of the esophagus. The aim of this pilot study was to determine the effectiveness and safety of percutaneous transgastric traction (PTT)-assisted ESD, a method that overcomes the drawbacks of conventional ESD, in a porcine model.
  
  
  METHODS
  Six domestic pigs (25-30 kg) were used in the study. In each animal, two 5-cm-long esophageal areas were assigned randomly for resection by conventional ESD or PTT-assisted ESD. The PTT method was designed to offer esophageal mucosal traction directed toward the stomach. The wire was introduced into the stomach through a percutaneous transgastric cannula and was fixed on the resected esophageal mucosa.
  
  
  RESULTS
  Submucosal dissection in the traction group required only half the time of that in the non-traction group (mean dissection time 596.0 vs. 1127.3 s, respectively; p = 0.01). At necropsy, no differences in the incidence of perforation or bleeding were found between two groups.
  
  
  CONCLUSIONS
  The PTT method can enhance the speed of submucosal dissection for esophageal ESD to completely remove large areas of resected mucosa.
authors.affiliation: Division of Gastroenterology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Peng-Jen
authors.initials: PJ
authors.lastname: Chen
authors.forename: Wen-Chien
authors.initials: WC
authors.lastname: Huang
authors.forename: Hsiu-Po
authors.initials: HP
authors.lastname: Wang
authors.forename: Wei-Kuo
authors.initials: WK
authors.lastname: Chang
authors.forename: Tsai-Yuan
authors.initials: TY
authors.lastname: Hsieh
authors.forename: Shou-Chuan
authors.initials: SC
authors.lastname: Shih
authors.forename: Horng-Yuan
authors.initials: HY
authors.lastname: Wang
authors.forename: Chia-Yuan
authors.initials: CY
authors.lastname: Liu
mesh_terms: D000818:Animals; D004210:Dissection / Q000009:adverse effects / Q000379:methods*; D004945:Esophagoscopy / Q000009:adverse effects / Q000379:methods*; D004947:Esophagus / Q000601:surgery*; D023421:Models, Animal; D009092:Mucous Membrane / Q000601:surgery*; D061646:Operative Time; D010865:Pilot Projects; D013270:Stomach / Q000601:surgery; D013552:Swine; D014143:Traction