The efficacy and safety of per-nasal “GTS partner” assisted traction technique for gastric endoscopic submucosal dissection - prospective single-center randomized clinical trial

Q: What is the goal of using the per-nasal “GTS partner” assisted traction technique in gastric ESD?

The study aims to assess the efficacy and safety of per-nasal “GTS partner” traction for improving gastric ESD performance, building on traction-assisted ESD effectiveness for flat digestive tract lesions.

Q: What were the main outcome differences between GTS-ESD and C-ESD?

GTS-ESD reduced median procedure time (38 vs 48 minutes) and increased resection speed overall, including lesions ≥20 mm, with similar en bloc and comparable R0 resection rates and no traction-related adverse events.

Sep 21, 2026

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Prospective, single-center randomized clinical trial evaluates per-nasal “GTS partner” assisted traction for gastric endoscopic submucosal dissection in patients with superficial gastric neoplasms. Conventional ESD (C-ESD) is compared with per-nasal “GTS partner” traction-assisted ESD (GTS-ESD) from Nov 2022 to May 2024. Primary endpoints are procedure time and dissection speed, with additional assessment of en bloc/R0 resection and adverse events. GTS-ESD shortens procedure time and increases resection speed without traction-related adverse events, while preserving mucosal safety.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Introduction

Rationale for traction in ESD

Snare traction approaches and limitations

Per-nasal “GTS partner” concept

Materials and methods

Study design

Surgical Endoscopy (2024) 38:7399–7408 [https://doi.org/10.1007/s00464-024-1](https://doi.org/10.1007/s00464-024-1)1347-z and Other Interventional Techniques The efficacy and safety of per‑nasal “GTS partner” assisted traction technique for gastric endoscopic submucosal dissection: a prospective single‑center randomized clinical trial Yu‑Zhen Bi1 · Li‑Min Zhou1 · Si‑Jia Yan1 · Yan Sun2 · Jun Zhang3 Received: 24 July 2024 / Accepted: 6 October 2024 / Published online: 23 October 2024 © The Author(s) 2024 Abstract Background Since the snare traction-assisted ESD has been proven effective in treating flat lesions of the digestive tract, we modified and innovated the process and path of the traditional snare entering the digestive tract, aiming to investigate the efficacy and safety of using the per-nasal “GTS partner” assisted traction technology in gastric ESD. Methods Patients with superficial gastric neoplasms were prospectively enrolled between November 2022 and May 2024 and randomly assigned to a conventional ESD (C-ESD) group or per-nasal “GTS partner” traction-assisted ESD (GTS-ESD) group. The primary outcomes were procedure time and dissection speed. Results The GTS-ESD and C-ESD groups included 40 patients each, and all the enrolled patients underwent the assigned treatment. The median procedure time in the GTS-ESD group was shorter than that in the C-ESD group (38 min vs. 48 min; P < 0 .001), and the mean resection speed of the GTS-ESD group was faster than that of the C-ESD group (17 .95 mm2/min vs. 11.86 mm2/min; P = 0.033) . The median resection speed of lesions ≥ 20 mm was faster by GTS-ESD than by C-ESD (21 .21 mm2/min vs. 12.83 mm2/min, P = 0.002) . The en bloc resection rate (100% vs 100%) and R0 resection rate (100% vs. 97.5%) were similar between the two groups. There were no adverse events related to the per-nasal “GTS partner” assisted traction technology, and the traction technology had little interference with the endoscopist. Conclusions The per-nasal “GTS partner” assisted traction technique can significantly shorten the gastric ESD procedure time and has the advantages of no damage to normal mucosa and adjustable traction direction, especially in the lower 1/3 of the stomach or lesions with a diameter of ≥ 20 mm. Keywords Snare · Traction · Partner · Endoscopic submucosal dissection Endoscopic submucosal dissection (ESD) is characterized by minimal trauma, good efficacy, and high technical Yu-Zhen Bi and Li-Min Zhou have contributed equally to this work. * Jun Zhang [zhangjun1@hmc.edu.cn](zhangjun1@hmc.edu.cn) 1 Department of Gastroenterology, Chun’an County First People’s Hospital (Zhejiang Provincial People’s Hospital, Chun’an Branch), Hangzhou, Zhejiang, P. R. China 2 Key Laboratory of Gastroenterology of Zhejiang Province, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, P. R. China 3 Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, Zhejiang 310003, P. R. China requirements. It is widely accepted as a minimally invasive treatment for patients with superficial gastrointestinal neoplasms [1] . According to long-term clinical observation, ESD can achieve the therapeutic effect of surgery, complete dissection of lesions, and accurate pathological evaluation [2 , 3] . Due to the characteristics of the endoscopic cavity, the endoscopist’s operating space is narrow, resulting in technical difficulties, time-consuming procedures, and adverse events such as bleeding and perforation [4] . The key to solving these technique difficulties is to achieve accurate dissection by maintaining adequate visualization of the submucosal dissection plane and tissue tension during the ESD procedure. The snare traction-assisted technology can achieve multidirection traction by pushing or pullin

FAQs

What is the goal of using the per-nasal “GTS partner” assisted traction technique in gastric ESD?

The study aims to assess the efficacy and safety of per-nasal “GTS partner” traction for improving gastric ESD performance, building on traction-assisted ESD effectiveness for flat digestive tract lesions.

How were patients assigned in the trial?

Patients with superficial gastric neoplasms were prospectively enrolled between November 2022 and May 2024 and randomly assigned to conventional ESD (C-ESD) or per-nasal “GTS partner” traction-assisted ESD (GTS-ESD).

What were the main outcome differences between GTS-ESD and C-ESD?

GTS-ESD reduced median procedure time (38 vs 48 minutes) and increased resection speed overall, including lesions ≥20 mm, with similar en bloc and comparable R0 resection rates and no traction-related adverse events.

Sep 21, 2026

Uploaded by Evangeline