title: Endoscopic submucosal dissection using the "Clutch Cutter" for early esophageal squamous cell carcinoma.
abstract: OBJECTIVE
  To reduce the risk of complications related to the use of knives in endoscopic submucosal dissection (ESD), we developed the Clutch Cutter which can grasp and incise targeted tissue using electrosurgical current, similarly to a biopsy technique. The study aim was to evaluate the efficacy and safety of ESD using the Clutch Cutter for early esophageal squamous cell carcinoma.
  
  
  METHODS
  ESD using the Clutch Cutter was performed on 32 consecutive patients with early esophageal squamous cell carcinoma. Therapeutic efficacy and safety were assessed.
  
  
  RESULTS
  All lesions were treated easily and safely without unintended incision. En bloc resection was obtained in all patients. Histologically negative margins were obtained in 26/32 patients (81%). Endoscopic perforation due to the hood in one patient (3%), mediastinitis without endoscopic perforation in one patient (3%), and post-ESD stricture in 5 patients (16%) were observed. All were successfully managed conservatively.
  
  
  CONCLUSIONS
  ESD using the Clutch Cutter appears to be a safe, easy, and technically efficient method for resecting early esophageal squamous cell carcinomas.
authors.affiliation: Department of Gastroenterology, Aso Iizuka Hospital, Iizuka, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Akahoshi
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Minoda
authors.forename: Keishi
authors.initials: K
authors.lastname: Komori
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Motomura
authors.forename: Masaru
authors.initials: M
authors.lastname: Kubokawa
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Otsuka
authors.forename: Syouhei
authors.initials: S
authors.lastname: Hamada
authors.forename: Shinichirou
authors.initials: S
authors.lastname: Fukuda
authors.forename: Risa
authors.initials: R
authors.lastname: Iwao
authors.forename: Junya
authors.initials: J
authors.lastname: Gibo
authors.forename: Masafumi
authors.initials: M
authors.lastname: Oya
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakamura
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004210:Dissection / Q000009:adverse effects / Q000295:instrumentation*; D004938:Esophageal Neoplasms / Q000601:surgery*; D004939:Esophageal Perforation / Q000209:etiology; D004940:Esophageal Stenosis / Q000209:etiology; D004945:Esophagoscopy / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000209:etiology; D008875:Middle Aged; D009092:Mucous Membrane / Q000601:surgery*; D011446:Prospective Studies