Table 2.
Clinical Outcomes between Traction-Assisted ESD and Conventional ESD of the Stomach
| Author (year) | Traction method | Design | Cases, n (study/control) |
Lesion size, mm (study/control) |
Specimen size, mm (study/control) |
Procedure time, min (study/control) |
En bloc resection, % (study/control) |
Complete resection, % (study/control) |
|---|---|---|---|---|---|---|---|---|
| Hijikata et al. (2012)27 | Sheath-assisted | Retrospective | 25/43 | 40.0/38.1† | - | 75.0/108.1† (p<0.05) | 100/100 | - |
| Okamoto et al. (2012)30 | Clip and line/clip line mounted on the scope |
Retrospective | 15/15/15 | 15/14/14* | - | 62/84/96* (p=0.019 | - | 100/100/100 |
| Ahn et al. (2013)22 | Double scope | RCT | 26/25 | 20.5/19.4† | - | 29.2/26.2† (p=0.33) | 100/100 | 96.2/96.0 |
| Higuchi et al. (2013)26 | Double scope | Retrospective | 30/27‡ | 20/18* | 45/43* | 80/101* (p=0.22) | 100/89 | 90/78 |
| Masumoto et al. (2013)28 | Elastic band | Retrospective | 37/37 | - | 39.8/32.6* | 3.18/6.3*,§ (p<0.01) | - | - |
| Suzuki et al. (2016)31 | Clip and line | Retrospective‖ | 43/43 | - | 37.3/39.3† | 82.2/118.2† (p=0.002) | 97.7/100 | 90.7/95.3 |
| Yoshida et al. (2016)32 | Clip and line | Retrospective | 95/104 | 17/16† | 46/46† | 43/52† (p<0.01) | 100/100 | 97.1/96.2 |
| Noda et al. (2016)29 | Clip and line with a snare sheath | Retrospective | 54/34 | - | 34/30* | 60/90* (p=0.015) | 100/97.1 | - |
| Yoshida et al. (2018)33 | Clip and line | RCT | 319/316 | 15.7/15.5† | 39.2/39.0† | 58.1/60.7† (p=0.45) | 100/100 | 97.8/96.8 |
| Hashimoto et al. (2018)25 | S-O clip | Retrospective‖ | 48/48 | - | 37.4/35.1† | 47.2/69.2† (p=0.035) | 100/100 | - |
| Feng et al. (2018)23 | Tunneling | Retrospective | 7/7 | - | 1,181.99/1,166.29†,¶ | 69.0/87.7† (p=0.01) | 100/100 | 85.7/100 |
| Harada et al. (2018)24 | Saline pocket | Retrospective‖ | 48/48 | 15.0/15.5* | 34.0/32.5* | 27.5/41.0* (p<0.001) | 100/100 | 97.9/95.8 |
| Zhang et al. (2019)34 | Tunneling | Retrospective | 32/55** | - | 1,573.0 vs 930.1†,¶ (p<0.01) |
83.7/136.7† (p<0.01) | 100/87.3 (p=0.035) |
- |
ESD, endoscopic submucosal dissection; RCT, randomized controlled trial.
*Median; †Mean; ‡Only early gastric cancer with ulceration; §Dissection time per cm2 (min/cm2); ‖Propensity score matching; ¶Specimen area (mm2); **Included only the lesion in the lesser curvature.