Objective: To evaluate the safety and efficacy of a composite knife by comparing the dual knife, IT knife, and composite knife in the treatment of esophageal lesions. Methods: Patients from First Affiliated Hospital of Guilin Medical University and Liuzhou People’s Hospital of Guangxi Medical University were selected as study subjects from May 2020 to May 2024. The patients were divided into three groups for surgery: 40 patients in the dual knife group, 40 patients in the IT knife group, and 40 patients in the composite knife group. The operation time, resection speed, complete resection rate, and complication rate of the three groups were compared. Results: The stripping speed was 22.80 ± 7.31 mm/min for the composite knife group, 19.20 ± 7.24 mm/min for the Dual-knife group, and 15.32 ± 6.2 mm/min for the IT knife group. The differences were statistically significant (t = 3.67, P = 0.03). The operation time for the composite knife group was 42.4 ± 19.79 min, which was significantly shorter than that for the dual knife group (66.21 ± 21.23 min) and the IT knife group (57.86 ± 24.61 min) (t = 2.67, P = 0.04). The operation time in the composite knife group was shorter than that in the dual knife group and the IT knife group. Additionally, the stripping speed was faster in the composite knife group than in the dual knife group and the IT knife group. The rates of whole piece excision and complete excision were similar in all three groups. The resection rate was similar among the three groups. One case of muscle layer injury (2.5%) occurred in each group. In the IT knife group, two cases of postoperative esophageal stenosis were reported, while in the dual-knife group and the composite knife group, one case of postoperative esophageal stenosis occurred each. The difference was not statistically significant (P = 0.45). Conclusion: Compared with the dual knife and IT knife methods, the composite knife technique can shorten the operation time and increase the speed of resection for endoscopic submucosal dissection of esophageal lesions. It also offers certain advantages in terms of safety and effectiveness.
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