Prospective randomized comparison of endoscopic submucosal tunnel dissection and conventional submucosal dissection in the resection of superficial esophageal/ XXXX in a living porcine model.

@entity1 @entity1707 @entity7634 @entity1819
BACKGROUND AND STUDY AIMS: To assess experimentally endoscopic submucosal tunnel dissection (ESTD) as an alternative technique of endoscopic submucosal resection. @entity1 AND METHODS: This was a prospective, randomized, comparative experimental animal study carried out over a period of 9 months at the surgical research and teaching center of Aix-Marseille University, France. Virtual esophageal and @entity1819 measuring 3cm in diameter were resected in @entity1707 weighing 25 to 30kg. The primary aim was to evaluate ESTD's efficacy compared with endoscopic submucosal dissection (ESD). The secondary aims were to determine complication rates as well as to assess procedure time and procedure speed, histologic quality of the resected specimen, and procedure cost. RESULTS: Eighteen procedures (9 ESD and 9 ESTD) were performed in nine @entity1707 . The technical success rate was 88.9% for both techniques, with one single failure in each. The en bloc resection rate was 100% for ESTD and 88.9% for ESD (one failure). The complication rate (22%) and median procedure time were similar but dissection speed was quicker with ESTD in the esophagus (P=0.03). Median procedure cost (728 @entity7634 for ESD and ESTD) did not differ. On histologic examination, the lateral margins were healthy in 100% of ESTD and in 88.9% of ESD (P=0.49). Deep resection margins were of better quality in ESTD (median submucosal thickness: 1307.1  m vs. 884.7  m; P=0.039). CONCLUSIONS: ESTD is feasible and safe but not superior in the treatment of superficial esophageal/ @entity1819 in porcine models compared with ESD. Nevertheless it provides a better quality histologic specimen.
