Peroral endoscopic esophagel myotomy (POEM) is a third space endoscopy technique that depends on creating a submucosal tunnel to expose the esophageal muscle and eventually perform an esophageal myotomy. Submucosal dissection can be performed using numerous electrosurgical modes. Spray coagulation has been anecdotally favored by many endoscopists due to its high coagulation power and assumed safety. Recently, Precisect mode has been developed, it has theoretical advantages of very minimal tissue penetration and minimal to no charring effect. In this trial, the investigators compare the efficacy and safety of both electrosurgical modes in POEM procedures.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
52
After initial mucosal incision, submucosal dissection will be performed down to 2cm below the cardia using Spray coag mode using ERBE VIO3 generator and a Hybrid knife (T-type) aided by ERBEJET for submucosal injection
After initial mucosal incision, submucosal dissection will be performed down to 2cm below the cardia using Precisect mode using ERBE VIO3 generator and a Hybrid knife (T-type) aided by ERBEJET for submucosal injection
Cairo University
Cairo, Egypt
RECRUITINGSpeed of endoscopic submucosal dissection
Speed of dissection (cm/minute)
Time frame: during the procedure
Intraprocedural Bleeding
Bleeding necessitating change in electrosurgical mode
Time frame: during the procedure
Significant Intraprocedural bleeding
Bleeding necessitating change of instrument to coagulating forceps
Time frame: during the procedure
Other Adverse events
Including mucosal injury, postoperative pain, postoperative bleeding and other complications
Time frame: during the procedure
Total procedure duration
Total procedure duration
Time frame: during the procedure
Endoscopic submucosal tunneling duration
Endoscopic submucosal tunneling duration
Time frame: during the procedure
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