Application of rubber ring endoluminal traction assisted by endoscopic mucosal dissection in the treatment of colorectal lateral developmental type lesions

To analyze the operating methods, safety and efficacy of rubber band endoluminal traction assisted by endoscopic mucosal dissection (ESD) in the treatment of colorectal lateral developmental type lesions.

Eighty-five patients with colorectal lateral developmental lesions undergoing ESD treatment admitted to Endoscopy Center of Nantong Cancer Hospital from January 2016 to June 2022 were selected as study objects, and all patients were treated with the elastic band endoluminal traction assisted by ESD technology (marking the lesion, submucosal injection, annular incision, fixation of the lesion by elastic band, complete dissection of the lesion). The complete resection rate, operation time of operation, intraoperative complications, postoperative complications and postoperative recurrence were observed.

The complete resection rate of 85 patients was 100.0%, the operative time was 30 to 110 min, with the median time of 55 min. There was 5 cases had a small amount of bleeding (with mean volume of 20 mL) during the operation, which was stopped by electric coagulation. Postoperative delayed perforation occurred in 1 patient and was improved after conservative treatment. Postoperative pathology of two patient suggested adenocarcinoma with submucosal infiltration greater than 1 000 μm. The peripheral margin was negative, and then additional treatment was given. One patient had postoperative perforation, and was improved after conservative treatment. During follow-up for 3 to 6 months, all patients had good wound healing without local recurrence.

Rubber band endoluminal traction assisted by ESD can provide the operator with a good view of the operation, shorten the operation time and reduce incidence rates of complications in intraoperation and postoperation.