Continuously liquid-sucking catheter attachment for the endoscope reduces the volume of liquid reflux to the mouth in esophageal endoscopic submucosal dissection.

OBJECTIVES: The pooling of the liquid in esophageal lumen can worsen the field of vision and cause liquid reflux to the mouth, which leads to aspiration pneumonia, in esophageal endoscopic submucosal dissection (ESD). We developed a continuously liquid-sucking catheter attachment for the endoscope (CLCA), which has multiple tiny holes and can suck the liquid without causing mucosal injury. Thus, we aimed to reveal the efficacy of CLCA in esophageal ESD.

METHODS: This was a single-blinded, randomized controlled trial involving patients with superficial esophageal cancer. The enrolled patients were randomly assigned to the conventional ESD (C-ESD) or ESD with CLCA (CLCA-ESD) groups. The primary endpoint was the volume of liquid reflux to the mouth during the ESD procedure. The secondary endpoints were the incidence of aspiration pneumonia and the procedure time.

RESULTS: Fifty patients were enrolled in this trial. The volume of liquid reflux to the mouth was significantly lower in the CLCA-ESD group than in the C-ESD group (mean: 10 vs. 73 mL, P =0.010). Furthermore, the incidence of aspiration pneumonia on computed tomography (CT) scan between the two groups was also significantly different (4.0% vs. 32.0%, P =0.023), although no significant difference was observed through chest radiography. In addition, the procedure time tended to be shorter in the CLCA-ESD group (P =0.054).

CONCLUSIONS: This study first revealed that the use of CLCA in esophageal ESD reduced the volume of liquid reflux to the mouth and contributed to the decreased incidence of aspiration pneumonia on CT scan (UMIN000018167). This article is protected by copyright. All rights reserved.