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Background <p>A Clutch Cutter is a grasping scissor forceps device used for endoscopic submucosal dissection (ESD). This device can grasp and incise the target tissue similar to the action of a biopsy forceps. Therefore, ESD with a Clutch Cutter may be easier and safer than that performed with non-scissor-type knives. This study verified the usefulness of the Clutch Cutter by nonexpert endoscopists during ESD for superficial esophageal cancer.</p> Methods <p>This single-center retrospective cohort study enrolled 125 patients who underwent ESD as a first-line therapy for superficial esophageal cancer between January 2016 and June 2023 at Saiseikai Suita Hospital. The patients were divided into groups based on the ESD device: a Clutch Cutter or a non-scissor-type device (dual knife). The clinical characteristics and technical outcomes were compared between the two groups.</p> Results <p>Among one hundred twenty-five patients, seventy-nine patients underwent nonexpert endoscopic treatment, of which twenty-one patients underwent ESD with a Clutch Cutter and fifty-eight patients with a dual knife. There is a significant difference in sex distribution between the two groups, with a higher percentage of males in the dual knife group (94.8%) compared to the Clutch Cutter group (71.4%) (<i>p</i> = 0.01). Patients in the Clutch Cutter group had shorter procedure times (60&#xa0;min) than those in the dual knife group (93&#xa0;min) (<i>p</i> = 0.002). However, en bloc and R0 resection rates were not significantly different between the groups. In the multivariate analysis, procedure time (min) was significantly correlated with device type (coefficient 58.86, 95% confidence interval: 26.99—90.72) and tumor size (coefficient 4.9, 95% confidence interval: 3.58—6.21).</p> Conclusion <p>ESD for superficial esophageal cancer with the Clutch Cutter significantly shortened procedure time compared to that with the dual knife for nonexpert endoscopists. Therefore, the Clutch Cutter may be a preferred-device for nonexpert endoscopists.</p>

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Comparative effectiveness of the Clutch Cutter versus Dual knife for esophageal endoscopic submucosal dissection by non-expert endoscopists: a single-center retrospective cohort study

  • 期刊论文

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  • 发表日期：

    2026年5月21日

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  • Kei Terasaki,
  • Kyoko Sakai,
  • Yoshimichi Yorioka,
  • Hidetomi Kimura,
  • Shinsaku Fujiishi,
  • Maho Fujinami,
  • Kazuhisa Watanabe,
  • Shohei Amioka,
  • Takahiro Nonaka,
  • Takahiro Miura,
  • Keiichiro Okuda,
  • Hirohisa Oya,
  • Takayuki Katayama,
  • Kohei Fukumoto,
  • Yasuhide Mitsumoto,
  • Chiemi Mizuno,
  • Toshihide Shima,
  • Takeshi Okanoue

摘要

Background

A Clutch Cutter is a grasping scissor forceps device used for endoscopic submucosal dissection (ESD). This device can grasp and incise the target tissue similar to the action of a biopsy forceps. Therefore, ESD with a Clutch Cutter may be easier and safer than that performed with non-scissor-type knives. This study verified the usefulness of the Clutch Cutter by nonexpert endoscopists during ESD for superficial esophageal cancer.

Methods

This single-center retrospective cohort study enrolled 125 patients who underwent ESD as a first-line therapy for superficial esophageal cancer between January 2016 and June 2023 at Saiseikai Suita Hospital. The patients were divided into groups based on the ESD device: a Clutch Cutter or a non-scissor-type device (dual knife). The clinical characteristics and technical outcomes were compared between the two groups.

Results

Among one hundred twenty-five patients, seventy-nine patients underwent nonexpert endoscopic treatment, of which twenty-one patients underwent ESD with a Clutch Cutter and fifty-eight patients with a dual knife. There is a significant difference in sex distribution between the two groups, with a higher percentage of males in the dual knife group (94.8%) compared to the Clutch Cutter group (71.4%) (p = 0.01). Patients in the Clutch Cutter group had shorter procedure times (60 min) than those in the dual knife group (93 min) (p = 0.002). However, en bloc and R0 resection rates were not significantly different between the groups. In the multivariate analysis, procedure time (min) was significantly correlated with device type (coefficient 58.86, 95% confidence interval: 26.99—90.72) and tumor size (coefficient 4.9, 95% confidence interval: 3.58—6.21).

Conclusion

ESD for superficial esophageal cancer with the Clutch Cutter significantly shortened procedure time compared to that with the dual knife for nonexpert endoscopists. Therefore, the Clutch Cutter may be a preferred-device for nonexpert endoscopists.