title: Endoscopic submucosal dissection with the Nestis®jet injector system with a bifunctional catheter: first prospective clinical trial (NCT: 2012-A00272-41).
abstract: The Enki-2 water jet system (Nestis SAS®, Lyon, France) with dual injection and dissection capability significantly reduced ESD procedure time and perforation rates in animal studies. The study aim was to evaluate its efficacy and safety in patients with superficial neoplastic lesions.
  
  
  
  A prospective study including 18 patients with esophageal, gastric and rectal superficial neoplasms treated by ESD using Enki-2 was designed.
  
  
  
  Eighteen lesions (6 esophageal, 3 gastric, 9 rectal, mean diameter 43.5 mm) in 17 patients (10 men, mean age 65.9) were included. The mean procedure time was 65.6 min. One patient needed clipping for an incomplete muscle tear during procedure; there were neither delayed bleedings nor perforation. The "en bloc" resection rate was 100 %, the R0 resection rate was 88.9 % (16/18 lesions), and the curative resection rate was 77.8 %. The 3-month disease-free rate was 92.3 % (12/13 patients, 13/14 lesions, 1 patient lost to follow-up). The 12-month disease-free rate was 69.2 % (9/13 patients, 10/14 lesions, 4 patients lost to follow-up).
  
  
  
  ESD with Enki-2 water jet system is effective and safe for superficial neoplastic digestive lesions.
authors.affiliation: Gastroenterology and Endoscopy, Edouard Herriot Hospital, Lyon Cedex, France. mathieupioche@free.fr.|Nestis, Lyon, France. mathieupioche@free.fr.|LabTau, Inserm U1032, Lyon Cedex, France. mathieupioche@free.fr.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Pioche
authors.affiliation: Gastroenterology and Endoscopy, Edouard Herriot Hospital, Lyon Cedex, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Lépilliez
authors.affiliation: Gastroenterology and Endoscopy, Edouard Herriot Hospital, Lyon Cedex, France.|Fundeni Gastroenterology Clinic, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Mihai
authors.initials: M
authors.lastname: Ciocîrlan
authors.affiliation: Gastroenterology and Endoscopy, Edouard Herriot Hospital, Lyon Cedex, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Rivory
authors.affiliation: Gastroenterology and Endoscopy, Edouard Herriot Hospital, Lyon Cedex, France.
authors.forename: Clothilde
authors.initials: C
authors.lastname: Miaglia
authors.affiliation: Pathology Department, Edouard Herriot Hospital, Lyon, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Hervieu
authors.affiliation: Visceral Surgery Department, Edouard Herriot Hospital, Lyon Cedex, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Poncet
authors.affiliation: Digestive Radiology Department, Edouard Herriot Hospital, Lyon Cedex, France.
authors.forename: Pierre-Jean
authors.initials: PJ
authors.lastname: Valette
authors.affiliation: Gastroenterology and Endoscopy, Edouard Herriot Hospital, Lyon Cedex, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Saurin
authors.affiliation: Gastroenterology and Endoscopy, Edouard Herriot Hospital, Lyon Cedex, France.|LabTau, Inserm U1032, Lyon Cedex, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Ponchon
mesh_terms: D000368:Aged; D057785:Catheters; D018572:Disease-Free Survival; D004210:Dissection / Q000295:instrumentation*; D000069916:Endoscopic Mucosal Resection / Q000295:instrumentation*; D004938:Esophageal Neoplasms / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000601:surgery; D013274:Stomach Neoplasms / Q000601:surgery
keywords: Endoscopic submucosal dissection; Superficial neoplasia; Water jet system