ArticleSurgical endoscopy2026
ENDOCUT Q coagulation fraction is associated with esophageal stricture after endoscopic submucosal dissection.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEndoscopic submucosal dissection (ESD) carries a substantial risk of esophageal stricture formation. We aimed to quantify the coagulation component embedded within ENDOCUT Q mode using a custom-developed energy sensor and to investigate its association with post-ESD esophageal stricture.
methodsPatients who underwent ESD for early esophageal cancer between 2021 and 2024 were retrospectively reviewed. A custom energy sensor was used to measure real-time electrosurgical output, allowing separate quantification of cutting and coagulation energy in ENDOCUT Q mode. The ENDOCUT Q coagulation fraction (ECF) was defined as the proportion of coagulation energy within total ENDOCUT Q energy. For exploratory categorical analyses, ECF was classified as low (< 1%), medium (1-10%), or high (> 10%) using cohort-derived thresholds. Independent factors associated with post-ESD esophageal stricture were identified using multivariable logistic regression.
resultsAmong 681 patients, post-ESD stricture occurred in 124 patients (18.2%). In multivariable analysis, circumferential extent > 3/4 (odds ratio [OR] 10.91, 95% confidence interval [CI] 4.94-24.11, p < 0.001), FORCED COAG energy density ≥ 22.02 J/cm
conclusionsECF was independently associated with post-ESD esophageal stricture. These findings suggest that coagulation-related thermal exposure may be associated with stricture formation and that ECF may serve as a potential quantifiable procedure-level marker of electrosurgical exposure.
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