# Efficacy and prognosis analysis of pulley traction-assisted endoscopic submucosal dissection with dental floss for early gastric cancer and precancerous lesions

**Authors:** Hao Luo, Jie Tang, Xiaotong He, Yinglei Shi, Yunli Chang

PMC · DOI: 10.3389/fsurg.2025.1477658 · Frontiers in Surgery · 2025-07-21

## TL;DR

Using a pulley traction method with dental floss during ESD improves outcomes for early gastric cancer and precancerous lesions.

## Contribution

Introduces pulley traction-assisted ESD with dental floss as a novel technique for treating early gastric cancer.

## Key findings

- The study group had higher curative and en bloc resection rates and lower residual lesion rates.
- Patients in the study group had less bleeding, shorter operation times, and fewer complications.
- The study group showed better gastrointestinal function recovery and lower recurrence rates.

## Abstract

To investigate the clinical efficacy of pulley traction-assisted endoscopic submucosal dissection (ESD) with dental floss in patients with early gastric cancer and precancerous lesions, and its impact on patient prognosis.

Clinical data of 77 patients with early gastric cancer and precancerous lesions were retrospectively analyzed. The patients were divided into groups according to different treatment regimens; 38 patients in the control group underwent ESD, whereas 39 patients in the study group underwent pulley traction-assisted ESD with dental floss. Lesion resection status, perioperative indicators, gastrointestinal function indicators, complications, and recurrence were compared between the two groups.

The curative and en bloc resection rates in the study group were significantly higher than those in the control group, whereas the residual rate of basal lesions was significantly lower than that in the control group (P < 0.05). The study group experienced less intraoperative bleeding and had a significantly shorter operative time, anal exhaust time, first eating time, and length of hospital stay (P < 0.05). Three days postoperatively, motilin (MTL), gastrin (GAS), pepsinogen I (PG I), and pepsinogen II (PG II) levels were significantly reduced in both groups, with significantly higher levels in the study group (P < 0.05). The incidence of complications in the study group was 7.69% (3/39), which was significantly lower than that in the control group [26.32% (10/38); P < 0.05]. Three months postoperatively, the quality of life scores (FACT-G) in all aspects significantly increased in both groups, with the study group showing significantly higher scores (P < 0.05). The recurrence rate at 12 months postoperatively in the study group (5.13%) was significantly lower than that in the control group (23.68%; P < 0.05).

Pulley traction-assisted ESD with dental floss is effective in treating early gastric cancer and precancerous lesions.

## Linked entities

- **Proteins:** mlnl (motilin-like), gastrin (gastrin/cholecystokinin-like peptide)
- **Diseases:** early gastric cancer (MONDO:0001060)

## Full-text entities

- **Genes:** GAST (gastrin) [NCBI Gene 2520] {aka GAS}, MLN (motilin) [NCBI Gene 4295], PGC (progastricsin) [NCBI Gene 5225] {aka PEPC, PGII}, BGN (biglycan) [NCBI Gene 633] {aka DSPG1, MRLS, PG-S1, PGI, SEMDX, SLRR1A}
- **Diseases:** gastrointestinal diseases (MESH:D005767), HL (MESH:C538324), precancerous lesions (MESH:D011230), hypoxia (MESH:D000860), bleeding (MESH:D006470), ischemia (MESH:D007511), trauma (MESH:D014947), mucosal defect (MESH:D052016), Gastric cancer (MESH:D013274), surgical trauma (MESH:D007431), pulmonary infection (MESH:D012141), lymph node metastasis (MESH:D008207), basal (MESH:D002280), metastasis (MESH:D009362), Complications (MESH:D008107), gastric lesion (MESH:D013272), intraepithelial neoplasia (MESH:D002578), intestinal obstruction (MESH:D007415), tissue injury (MESH:D017695), metabolic disorders (MESH:D008659), malignancies (MESH:D009369), inflammatory (MESH:D007249)
- **Chemicals:** sodium chloride (MESH:D012965), adrenaline (MESH:D004837), catecholamines (MESH:D002395), methylene blue (MESH:D008751), titanium (MESH:D014025), nylon (MESH:D009757)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

6 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12319019/full.md

## References

28 references — full list in the complete paper: https://tomesphere.com/paper/PMC12319019/full.md

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Source: https://tomesphere.com/paper/PMC12319019