Feasibility of Simple Traction Technique for Rectal Endoscopic Submucosal Dissection.

BACKGROUND AND AIMS: Rectal endoscopic submucosal dissection (ESD) is a highly effective procedure that achieves high en bloc resection regardless of lesion size or location. However, rectal ESD has a higher risk of intraoperative and postoperative bleeding and still difficult for beginners. Therefore, we designed a novel traction technique "traction-assisted rectal ESD using a clip-with-line (TAREC)," and investigated its feasibility.

METHODS: Between December 2014 and July 2015, ten patients with rectal neoplasms (median size 36 mm; range 20-125 mm) were treated using the TAREC technique.

RESULTS: In all lesions, good visibility of the submucosal layer was obtained, and the submucosal layer was dissected easily under direct visualization. All lesions were removed en bloc, and there were no procedure-related adverse events including postoperative bleeding. In particular, we experienced no intraoperative bleeding, which may be difficult to stop in some circumstances.

CONCLUSIONS: The TAREC technique is a simple and generally applicable procedure. This technique is feasible for rectal ESD.