Clin Endosc.  2022 Nov;55(6):767-774. 10.5946/ce.2022.002.

Comparison between a novel core knife and the conventional IT knife 2 for endoscopic submucosal dissection of gastric mucosal lesions

• Park M
• Lee JW
• Shin DW
• Kim J
• Lee YJ
• Lee JY
• Cho KB

• KMID: 2536077
• DOI: http://doi.org/10.5946/ce.2022.002

Abstract

Background/Aims
Few studies have compared the performances of endoscopic knives. This study aimed to compare the therapeutic outcomes of a novel core knife and the conventional IT knife 2 for endoscopic submucosal dissection (ESD) of gastric mucosal lesions.
Methods
This prospective, non-inferiority trial included patients diagnosed with gastric adenoma or early-stage adenocarcinoma at Keimyung University Dongsan Hospital between June and November 2020. The patients were randomly assigned to either the core knife or the IT knife 2 group. The operators and assistants scored the knives’ grip convenience and cutting abilities.
Results
A total of 39 patients were enrolled (core knife group, 20 patients; IT knife 2 group, 19 patients). There were no significant between-group differences in operator-assessed grip convenience (9.600 vs. 9.526, p=0.753), cutting ability (9.600 vs. 9.105, p=0.158), or assistant-assessed grip convenience (9.500 vs. 9.368, p=0.574).
Conclusions
The core knife achieved therapeutic outcomes that were comparable to those of the IT knife 2 for ESD of gastric mucosal lesions.

Keyword

Core knife; Endoscopic submucosal dissection; IT knife 2

Figure

• 

  Fig. 1. Knives used in endoscopic submucosal dissection. (A) Core knife (CORE-Knife, IC-KNA001; INCORE, Daegu, Korea). (B) IT knife 2 (IT knife2, KD-611L; Olympus).

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  Fig. 2. Endoscopic submucosal dissection using a novel core knife. (A) Marking: the tip of the knife is used for marking the margin for resection. (B) Incision: an incision is made around the circumference of the lesion. (C–E) Submucosal dissection: the submucosa is dissected with care to avoid perforation. (F) Excised specimen.

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  Fig. 3. Comparison of outcome measures between the two knives. (A) Operator and assistant convenience. (B) Procedure time (time A, time from marking to resection; time B, time spent on hemostasis; total procedure time=time A+time B).

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