Usefulness of the Bridge Formation Method for Colorectal Endoscopic Submucosal Dissection: A Propensity Score‐Matched Study

ABSTRACT Aims Colorectal endoscopic submucosal dissection (ESD) has become a standard treatment for superficial colorectal neoplasms worldwide. However, challenges remain in achieving dissection at the precise layer. In this study, we evaluated the effectiveness of a novel ESD technique involving na...

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Main Authors: Masahiro Abe, Takemasa Hayashi, Yuta Kouyama, Yutaro Ide, Tomoya Shibuya, Yuriko Morita, Kenichi Mochizuki, Yosuke Minegishi, Eri Tamura, Taishi Okumura, Tatsuya Sakurai, Yushi Ogawa, Yasuharu Maeda, Katsuro Ichimasa, Naoya Toyoshima, Masashi Misawa, Kunihiko Wakamura, Naruhiko Sawada, Toshiyuki Baba, Tetsuo Nemoto, Shin‐ei Kudo
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:JGH Open
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Online Access:https://doi.org/10.1002/jgh3.70149
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author Masahiro Abe
Takemasa Hayashi
Yuta Kouyama
Yutaro Ide
Tomoya Shibuya
Yuriko Morita
Kenichi Mochizuki
Yosuke Minegishi
Eri Tamura
Taishi Okumura
Tatsuya Sakurai
Yushi Ogawa
Yasuharu Maeda
Katsuro Ichimasa
Naoya Toyoshima
Masashi Misawa
Kunihiko Wakamura
Naruhiko Sawada
Toshiyuki Baba
Tetsuo Nemoto
Shin‐ei Kudo
author_facet Masahiro Abe
Takemasa Hayashi
Yuta Kouyama
Yutaro Ide
Tomoya Shibuya
Yuriko Morita
Kenichi Mochizuki
Yosuke Minegishi
Eri Tamura
Taishi Okumura
Tatsuya Sakurai
Yushi Ogawa
Yasuharu Maeda
Katsuro Ichimasa
Naoya Toyoshima
Masashi Misawa
Kunihiko Wakamura
Naruhiko Sawada
Toshiyuki Baba
Tetsuo Nemoto
Shin‐ei Kudo
author_sort Masahiro Abe
collection DOAJ
description ABSTRACT Aims Colorectal endoscopic submucosal dissection (ESD) has become a standard treatment for superficial colorectal neoplasms worldwide. However, challenges remain in achieving dissection at the precise layer. In this study, we evaluated the effectiveness of a novel ESD technique involving natural traction, referred to as the bridge formation method (BFM). Methods and Results The two main features of the BFM are creating a large mucosal flap and leaving normal mucosa on both sides of the lesion until the bridge is made at the end of the procedure. This retrospective study included consecutive patients with 2647 colorectal lesions resected by ESD from September 2003 to December 2023. We divided them into the BFM group and the non‐BFM group and conducted propensity score matching. After propensity score matching, 1648 cases were enrolled (824 cases in each group). The en bloc resection rate was significantly higher in the BFM than non‐BFM group (99.6% vs. 96.7%, p < 0.01). The R0 resection rate and the average dissection speed (㎟/min) were significantly higher in the BFM than non‐BFM group (98.8% vs. 96.4%, p < 0.01, and 18.9 vs. 18.0, p = 0.03). The occurrence rates of perforation and delayed bleeding showed no significant difference between the non‐BFM and BFM groups (2.8% vs. 3.6%, p = 0.40, and 1.1% vs. 1.0%, p = 1.00). Conclusions The BFM is a suitable method for colorectal ESD as it enables rapid dissection and improves both en bloc resection and R0 resection rates.
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spelling doaj-art-9ae80fe1e192495a996433aedcad8e302025-08-20T03:14:13ZengWileyJGH Open2397-90702025-04-0194n/an/a10.1002/jgh3.70149Usefulness of the Bridge Formation Method for Colorectal Endoscopic Submucosal Dissection: A Propensity Score‐Matched StudyMasahiro Abe0Takemasa Hayashi1Yuta Kouyama2Yutaro Ide3Tomoya Shibuya4Yuriko Morita5Kenichi Mochizuki6Yosuke Minegishi7Eri Tamura8Taishi Okumura9Tatsuya Sakurai10Yushi Ogawa11Yasuharu Maeda12Katsuro Ichimasa13Naoya Toyoshima14Masashi Misawa15Kunihiko Wakamura16Naruhiko Sawada17Toshiyuki Baba18Tetsuo Nemoto19Shin‐ei Kudo20Digestive Disease Center Showa University Northern Yokohama Hospital Yokohama Kanagawa JapanDigestive Disease Center Showa University Northern Yokohama Hospital Yokohama Kanagawa JapanDigestive Disease Center Showa University Northern Yokohama Hospital Yokohama Kanagawa JapanDigestive Disease Center Showa University Northern Yokohama Hospital Yokohama Kanagawa JapanDigestive Disease Center Showa University Northern Yokohama Hospital Yokohama Kanagawa JapanDigestive Disease Center Showa University Northern Yokohama Hospital Yokohama Kanagawa JapanDigestive Disease Center Showa University Northern Yokohama Hospital Yokohama Kanagawa JapanDigestive Disease Center Showa University Northern Yokohama Hospital Yokohama Kanagawa JapanDigestive Disease Center Showa University Northern Yokohama Hospital Yokohama Kanagawa JapanDigestive Disease Center Showa University Northern Yokohama Hospital Yokohama Kanagawa JapanDigestive Disease Center Showa University Northern Yokohama Hospital Yokohama Kanagawa JapanDigestive Disease Center Showa University Northern Yokohama Hospital Yokohama Kanagawa JapanDigestive Disease Center Showa University Northern Yokohama Hospital Yokohama Kanagawa JapanDigestive Disease Center Showa University Northern Yokohama Hospital Yokohama Kanagawa JapanDigestive Disease Center Showa University Northern Yokohama Hospital Yokohama Kanagawa JapanDigestive Disease Center Showa University Northern Yokohama Hospital Yokohama Kanagawa JapanDigestive Disease Center Showa University Northern Yokohama Hospital Yokohama Kanagawa JapanDigestive Disease Center Showa University Northern Yokohama Hospital Yokohama Kanagawa JapanDigestive Disease Center Showa University Northern Yokohama Hospital Yokohama Kanagawa JapanDepartment of Diagnostic Pathology and Laboratory Medicine Showa University Northern Yokohama Hospital Yokohama Kanagawa JapanDigestive Disease Center Showa University Northern Yokohama Hospital Yokohama Kanagawa JapanABSTRACT Aims Colorectal endoscopic submucosal dissection (ESD) has become a standard treatment for superficial colorectal neoplasms worldwide. However, challenges remain in achieving dissection at the precise layer. In this study, we evaluated the effectiveness of a novel ESD technique involving natural traction, referred to as the bridge formation method (BFM). Methods and Results The two main features of the BFM are creating a large mucosal flap and leaving normal mucosa on both sides of the lesion until the bridge is made at the end of the procedure. This retrospective study included consecutive patients with 2647 colorectal lesions resected by ESD from September 2003 to December 2023. We divided them into the BFM group and the non‐BFM group and conducted propensity score matching. After propensity score matching, 1648 cases were enrolled (824 cases in each group). The en bloc resection rate was significantly higher in the BFM than non‐BFM group (99.6% vs. 96.7%, p < 0.01). The R0 resection rate and the average dissection speed (㎟/min) were significantly higher in the BFM than non‐BFM group (98.8% vs. 96.4%, p < 0.01, and 18.9 vs. 18.0, p = 0.03). The occurrence rates of perforation and delayed bleeding showed no significant difference between the non‐BFM and BFM groups (2.8% vs. 3.6%, p = 0.40, and 1.1% vs. 1.0%, p = 1.00). Conclusions The BFM is a suitable method for colorectal ESD as it enables rapid dissection and improves both en bloc resection and R0 resection rates.https://doi.org/10.1002/jgh3.70149bridge formation methodcolorectal endoscopic submucosal dissectioncolorectal neoplasmpropensity score matching
spellingShingle Masahiro Abe
Takemasa Hayashi
Yuta Kouyama
Yutaro Ide
Tomoya Shibuya
Yuriko Morita
Kenichi Mochizuki
Yosuke Minegishi
Eri Tamura
Taishi Okumura
Tatsuya Sakurai
Yushi Ogawa
Yasuharu Maeda
Katsuro Ichimasa
Naoya Toyoshima
Masashi Misawa
Kunihiko Wakamura
Naruhiko Sawada
Toshiyuki Baba
Tetsuo Nemoto
Shin‐ei Kudo
Usefulness of the Bridge Formation Method for Colorectal Endoscopic Submucosal Dissection: A Propensity Score‐Matched Study
JGH Open
bridge formation method
colorectal endoscopic submucosal dissection
colorectal neoplasm
propensity score matching
title Usefulness of the Bridge Formation Method for Colorectal Endoscopic Submucosal Dissection: A Propensity Score‐Matched Study
title_full Usefulness of the Bridge Formation Method for Colorectal Endoscopic Submucosal Dissection: A Propensity Score‐Matched Study
title_fullStr Usefulness of the Bridge Formation Method for Colorectal Endoscopic Submucosal Dissection: A Propensity Score‐Matched Study
title_full_unstemmed Usefulness of the Bridge Formation Method for Colorectal Endoscopic Submucosal Dissection: A Propensity Score‐Matched Study
title_short Usefulness of the Bridge Formation Method for Colorectal Endoscopic Submucosal Dissection: A Propensity Score‐Matched Study
title_sort usefulness of the bridge formation method for colorectal endoscopic submucosal dissection a propensity score matched study
topic bridge formation method
colorectal endoscopic submucosal dissection
colorectal neoplasm
propensity score matching
url https://doi.org/10.1002/jgh3.70149
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