Evidence map›Paper›PMID 41430461›Full record

ArticleSurgical endoscopy2026

Dual-operator thin endoscope combination surgery for endoscopic submucosal dissection of gastrointestinal epithelial neoplasms: a single-center retrospective pilot study.

Takuma Okamura, Tomonari Ikeda, Miruki Yoshino, Tetsuro Honda, Tatsuki Ichikawa, Hisamitsu Miyaaki

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Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Takuma OkamuraDepartment of Gastroenterology, Nagasaki Harbor Medical Center, 6-39, Shinchi-Machi, Nagasaki City, Nagasaki, 850-8555, Japan. taku.okamu1002@gmail.com.ORCID 0009-0009-2826-5813
Tomonari IkedaDepartment of Gastroenterology, Nagasaki Harbor Medical Center, 6-39, Shinchi-Machi, Nagasaki City, Nagasaki, 850-8555, Japan.
Miruki YoshinoDepartment of Gastroenterology, Nagasaki Harbor Medical Center, 6-39, Shinchi-Machi, Nagasaki City, Nagasaki, 850-8555, Japan.
Tetsuro HondaHonda Internal Medicine and Endoscopy Clinic, Nagasaki, Japan.
Tatsuki IchikawaDepartment of Gastroenterology, Nagasaki Harbor Medical Center, 6-39, Shinchi-Machi, Nagasaki City, Nagasaki, 850-8555, Japan.
Hisamitsu MiyaakiDepartment of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThin endoscope combination surgery (TECS) is a dual-operator technique using two identical thin therapeutic endoscopes to enable dynamic traction and task sharing during advanced endoscopic treatment. This study aimed to evaluate the feasibility, safety, and procedural characteristics of TECS in clinical practice and characterize the learning curve for a fixed operator-assistant team adopting this approach.

methodsWe retrospectively analyzed the data of consecutive patients who underwent TECS for gastrointestinal epithelial tumors between January and December 2024. The primary outcome was technical success without conversion. Secondary outcomes included en bloc and R0 resection, treatment time, resection speed, and adverse events (AEs; captured during hospitalization and within 30 days).

resultsForty-five patients were enrolled; one was excluded for inadequate sedation, leaving 44 eligible. TECS was completed in 43 cases (26 gastric, 17 colorectal); 41 epithelial neoplasms were included in efficacy analyses. En bloc and R0 resection were achieved in all neoplastic cases. No intra- or delayed AEs occurred in the 43 completed procedures (0/43; two-sided 95% confidence interval [CI], 0.0-8.2). In a learning-curve subset performed by a fixed operator-assistant team (n = 32), median treatment time decreased from 59 to 27 min (p = 0.003), and median resection speed increased from 20.9 to 48.4 mm

conclusionsTECS was feasible and safe in this pilot series, enabling continuously adjustable, bidirectional traction and task sharing. Prospective multicenter studies are warranted to validate indications, safety, reproducibility, and cost-effectiveness.

Indexed as

Endoscopes, GastrointestinalEndoscopic Mucosal ResectionGastrointestinal NeoplasmsAdultAgedAged, 80 and overFeasibility StudiesFemaleHumansLearning CurveMaleMiddle AgedOperative TimePilot ProjectsRetrospective StudiesDual-operator techniqueEndoscopic submucosal dissectionGastrointestinal neoplasmsLearning curveResection speedTraction

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.