title: Impact of the clip and snare method using the prelooping technique for colorectal endoscopic submucosal dissection.
abstract: OBJECTIVE
  Endoscopic submucosal dissection (ESD) is more difficult to perform for colorectal tumors, but the use of traction to facilitate direct submucosal layer visualization is a promising method to reduce procedure times and complication rates. This study aimed to evaluate the efficacy and safety of the clip and snare method (CSM) with a prelooping technique (PLT) for colorectal tumors.
  
  
  METHODS
  A total of 140 colorectal tumors were treated: 17 using the CSM with PLT; 123, used as controls, by standard ESD without these techniques. Therapeutic efficacy and safety were retrospectively assessed.
  
  
  RESULTS
  All tumors were successfully resected en bloc using the CSM with PLT. Multisegment resection was found in four tumors in the control group.  There was a significant difference in the procedure time between the patients in the CSM with PLT group and the control group (45.6 vs. 70.1 minutes; P = 0.047). There were no significant differences in the complication rates (5.9 % vs. 8.1 %; P = 1.00).
  
  
  CONCLUSIONS
  The CSM with PLT was effective and safe in this study.
authors.affiliation: Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Doyama
authors.affiliation: Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Ota
authors.affiliation: Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Takeda
authors.affiliation: Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Tsuji
authors.affiliation: Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
authors.forename: Shigetsugu
authors.initials: S
authors.lastname: Tsuji
authors.affiliation: Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Yoshida
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000236:Adenoma / Q000601:surgery*; D000368:Aged; D003113:Colonoscopy / Q000295:instrumentation / Q000379:methods*; D015179:Colorectal Neoplasms / Q000601:surgery*; D000069916:Endoscopic Mucosal Resection / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome