Three-dimensional flexible endoscopy enables more accurate endoscopic recognition and endoscopic submucosal dissection m
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and Other Interventional Techniques
Three‑dimensional flexible endoscopy enables more accurate endoscopic recognition and endoscopic submucosal dissection marking for superficial gastric neoplasia: a pilot study to compare two‑ and three‑dimensional imaging Kazutoshi Higuchi1 · Mitsuru Kaise1 · Hiroto Noda1 · Kumiko Kirita1 · Eriko Koizumi1 · Takamitsu Umeda1 · Teppei Akimoto1 · Jun Omori1 · Naohiko Akimoto1 · Osamu Goto1 · Atsushi Tatsuguchi1,2 · Katsuhiko Iwakiri1 Received: 2 July 2020 / Accepted: 21 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Three-dimensional (3D) visualization offers better depth recognition than two-dimensional (2D) imaging, thus helping to provide more useful information. We compared 3D and 2D endoscopy with regard to endoscopic recognition and endoscopic submucosal dissection (ESD) marking for superficial gastric neoplasia. Methods ESD marking was performed on half of a neoplasia margin under 2D observation and the on other half under 3D observation for 28 gastric lesions (26 early gastric cancers and 2 adenomas). The accuracy of ESD marking was evaluated based on the distance between the pathological and endoscopic neoplasia margins measured on histology sections of ESD specimens. The technical ease of ESD marking and endoscopic lesion recognition (lesion morphology, lesion extent, and comprehensive endoscopic cognition) were assessed using visual analog scale (VAS) questionnaires. Results The mean distance between the pathological and endoscopic margins under 3D observation (1.03 ± 0.80 mm) was significantly (p = 0.002) shorter than that under 2D observation (1.94 ± 1.96 mm). The VAS for technical ease of ESD marking under 3D observation was significantly better (p
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