TY - JOUR
T1 - Efficacy and safety of grasping forceps-assisted endoscopic resection for gastric neoplasms
T2 - A multi-centre retrospective study
AU - Ichijima, Ryoji
AU - Suzuki, Sho
AU - Esaki, Mitsuru
AU - Horii, Toshiki
AU - Kusano, Chika
AU - Ikehara, Hisatomo
AU - Gotoda, Takuji
N1 - Publisher Copyright:
© 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
PY - 2021
Y1 - 2021
N2 - BACKGROUND Endoscopic submucosal dissection (ESD) is widely accepted for early gastric cancer (EGC) without lymph node metastasis, although ESD is challenging, even for small lesions, in the greater curvature (GC) of the upper (U) and middle (M) thirds of the stomach. Grasping forceps-assisted endoscopic resection (GF-ER) is a type of endoscopic mucosal resection that is performed via a double-channel endoscope. AIM To investigate the safety and efficacy of GF-ER vs ESD in the GC of the stomach’s U and M regions. METHODS We retrospectively reviewed the medical records of 506 patients who underwent ER of 522 EGC lesions in the stomach’s U and M regions in three institutions between January 2016 and May 2020. Nine lesions from eight patients who underwent GF-ER for EGC (the GF-ER group) were compared to 63 lesions from 63 patients who underwent ESD (the ESD group). We also performed a subgroup analysis of small lesions (< 10 mm) in 6 patients (7 lesions) from the GF-ER group and 20 patients (20 lesions) from the ESD group. RESULTS There were no statistically significant differences between the GF-ER and ESD groups in the en bloc resection rates (100% vs 100%) and the R0 resection rates (100% vs 98.4%). The median procedure time in the GF-ER group was shorter than that in the ESD group (4.0 min vs 55.0 min, P < 0.01). There were no adverse events in the GF-ER group, although five perforations (8.0%) and 1 case of postoperative bleeding (1.6%) were observed in the ESD group. When we only considered lesions that were < 10 mm, the median procedure time in the GF-ER group was still shorter than that in the ESD group (4.0 min vs 35.0 min, P < 0.01). There were no adverse events in the GF-ER group, although 1 case of perforation (1.6%) were observed in the ESD group. CONCLUSION These findings suggest that GF-ER may be an effective therapeutic option for small lesions in the GC of the stomach’s U and M regions.
AB - BACKGROUND Endoscopic submucosal dissection (ESD) is widely accepted for early gastric cancer (EGC) without lymph node metastasis, although ESD is challenging, even for small lesions, in the greater curvature (GC) of the upper (U) and middle (M) thirds of the stomach. Grasping forceps-assisted endoscopic resection (GF-ER) is a type of endoscopic mucosal resection that is performed via a double-channel endoscope. AIM To investigate the safety and efficacy of GF-ER vs ESD in the GC of the stomach’s U and M regions. METHODS We retrospectively reviewed the medical records of 506 patients who underwent ER of 522 EGC lesions in the stomach’s U and M regions in three institutions between January 2016 and May 2020. Nine lesions from eight patients who underwent GF-ER for EGC (the GF-ER group) were compared to 63 lesions from 63 patients who underwent ESD (the ESD group). We also performed a subgroup analysis of small lesions (< 10 mm) in 6 patients (7 lesions) from the GF-ER group and 20 patients (20 lesions) from the ESD group. RESULTS There were no statistically significant differences between the GF-ER and ESD groups in the en bloc resection rates (100% vs 100%) and the R0 resection rates (100% vs 98.4%). The median procedure time in the GF-ER group was shorter than that in the ESD group (4.0 min vs 55.0 min, P < 0.01). There were no adverse events in the GF-ER group, although five perforations (8.0%) and 1 case of postoperative bleeding (1.6%) were observed in the ESD group. When we only considered lesions that were < 10 mm, the median procedure time in the GF-ER group was still shorter than that in the ESD group (4.0 min vs 35.0 min, P < 0.01). There were no adverse events in the GF-ER group, although 1 case of perforation (1.6%) were observed in the ESD group. CONCLUSION These findings suggest that GF-ER may be an effective therapeutic option for small lesions in the GC of the stomach’s U and M regions.
KW - Endoscopic mucosal resection
KW - Endoscopic resection
KW - Endoscopic submucosal dissection
KW - Gastric cancer
KW - Grasping forceps-assisted endoscopic resection
UR - http://www.scopus.com/inward/record.url?scp=85103131234&partnerID=8YFLogxK
U2 - 10.4251/wjgo.v13.i3.174
DO - 10.4251/wjgo.v13.i3.174
M3 - Article
AN - SCOPUS:85103131234
SN - 1948-5204
VL - 13
SP - 174
EP - 184
JO - World Journal of Gastrointestinal Oncology
JF - World Journal of Gastrointestinal Oncology
IS - 3
ER -