title: ENDOSCOPIC GASTRIC SUBMUCOSAL DISSECTION: experimental comparative protocol between standard technique and Hybrid-Knife(r).
abstract: BACKGROUND
  Endoscopic treatment of superficial gastrointestinal tumors is routinely performed, however the advantages and shortcomings of submucosal pressure-jet dissection is still debated.
  
  
  OBJECTIVE
  - Aiming to compare this technique with conventional submucosal dissection, a study was designed in pigs.
  
  
  METHODS
  - Areas of the antral mucosa of the stomach with a diameter of 2 cm2 (6 per animal) were marked, and resected by means of the hybrid-knife (experimental technique), and Flush-knife or IT-knife (controls). An ERBE ICC 300 electrosurgical unit was adopted. End-points were procedural time, complications, and quality of the resected specimen.
  
  
  RESULTS
  - A total of 27 interventions were conducted in five animals. Time spent with the two options was quite short, and similar: 9.5±3.1 vs 8.0±3.0 minutes (P=0.21). Complications didn't differ (three per group, not significant), and removed specimen looked adequate in both circumstances.
  
  
  CONCLUSIONS
  - The hybrid-knife technique is an acceptable alternative to submucosal dissection, showing no difference compared to the standard technique taking into consideration the procedure, the presence of complications and the quality of the resected specimen.
authors.affiliation: Unidade de Endoscopia Gastrointestinal, Departamento de Cirurgia, Hospital das Clínicas, Universidade de São Paulo, SP, Brasil.
authors.forename: Ernesto Quaresma
authors.initials: EQ
authors.lastname: Mendonça
authors.affiliation: Unidade de Endoscopia Gastrointestinal, Departamento de Cirurgia, Hospital das Clínicas, Universidade de São Paulo, SP, Brasil.
authors.forename: Lucas Snioka
authors.initials: LS
authors.lastname: Zuretti
authors.affiliation: Unidade de Endoscopia Gastrointestinal, Departamento de Cirurgia, Hospital das Clínicas, Universidade de São Paulo, SP, Brasil.
authors.forename: Thiago
authors.initials: T
authors.lastname: Panzani
authors.affiliation: Unidade de Endoscopia Gastrointestinal, Departamento de Cirurgia, Hospital das Clínicas, Universidade de São Paulo, SP, Brasil.
authors.forename: Marianny
authors.initials: M
authors.lastname: Sulbaran
authors.affiliation: Unidade de Endoscopia Gastrointestinal, Departamento de Cirurgia, Hospital das Clínicas, Universidade de São Paulo, SP, Brasil.
authors.forename: Christiano Makoto
authors.initials: CM
authors.lastname: Sakai
authors.affiliation: Unidade de Endoscopia Gastrointestinal, Departamento de Cirurgia, Hospital das Clínicas, Universidade de São Paulo, SP, Brasil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Sakai
mesh_terms: D000818:Animals; D004598:Electrosurgery / Q000295:instrumentation; D000069916:Endoscopic Mucosal Resection / Q000295:instrumentation / Q000379:methods*; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery*; D007277:Injections, Jet / Q000295:instrumentation; D007431:Intraoperative Complications / Q000601:surgery*; D023421:Models, Animal; D061646:Operative Time; D011897:Random Allocation; D013552:Swine