Comparing a conventional and a spring-and-loop with clip traction method of endoscopic submucosal dissection for superficial gastric neoplasms: a randomized controlled trial (with videos)

Background and AimsSeveral traction methods have sought to overcome the technical difficulties of endoscopic submucosal dissection (ESD). However, direction has remained limited in most these methods, with lack clarity about optimal method for gastric ESD. A spring-and-loop clip (SLC) been developed as a multidirectional device. Here, we investigated whether SLC traction-assisted ESD (SLC-ESD) improved procedure-related outcomes compared conventional (C-ESD) among patients superficial neoplasms.MethodsThis single-center randomized controlled trial included neoplasms undergoing SLC-ESD or C-ESD between October 2018 December 2019. Using function, set vertical wall SLC-ESD. The primary outcome was median procedure time ESD.ResultsThe groups comprised 40 each, all enrolled underwent assigned treatment. significantly shorter group (29.1 minutes) than (52.6 minutes; P = .005). had mean attachment 1.82 minutes. En bloc resection achieved without perforation both groups.ConclusionsOur findings suggest that reduces increasing risk is appropriate (Clinical registration number: UMIN 000034533.) Several neoplasms. This groups. Our