Efficacy and safety of endoscopic submucosal dissection for pyloric neoplasms.

IF 2.7 2区医学 Q2 SURGERY

Surgical Endoscopy And Other Interventional Techniques Pub Date : 2025-09-16 DOI:10.1007/s00464-025-12061-0

Shao-Bin Luo, Zu-Qiang Liu, Li Wang, Yi-Qun Zhang, Ming-Yan Cai, Quan-Lin Li, Ping-Hong Zhou

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引用次数: 0

Abstract

Background and aims: Although endoscopic resection is widely accepted for pyloric lesions, endoscopic submucosal dissection (ESD) of pyloric neoplasms remains technically challenging. The study aimed to assess the efficacy and safety of ESD for pyloric neoplasms.

Methods: From June 2011 to August 2024, we retrospectively analyzed 103 patients with pyloric neoplasms who underwent ESD at the Endoscopy Center of Zhongshan Hospital. Clinical data,‌ including patient demographics, procedural outcomes, and follow-up results, were collected.

Results: Among 103 lesions, there were 36 prepyloric neoplasms, 49 pyloric neoplasms and 18 postpyloric neoplasms. The median lesion size was 31 mm (range 10-85 mm). The postpyloric group showed longer procedure duration (32 min vs. 39 min vs. 46 min, P = 0.029) and lower rate of en bloc resection (100.0% vs. 95.9% vs. 83.3%, P = 0.026) compared with the prepyloric group and pyloric group. No patients required conversion to open surgery. After procedure, delayed bleeding occurred in ‌one patient each‌ from the prepyloric and pyloric groups. During a median follow-up of 25 months (range: 6-81 months), only ‌one recurrence‌ (pyloric group) was observed. Post-ESD pyloric stenosis developed in 5 patients, all of whom achieved ‌symptomatic relief‌ through endoscopic balloon dilation (EBD) without complications.

Conclusions: ESD is a feasible and safe treatment for pyloric neoplasms. Additionally, EBD appears to be a safe and effective ‌therapeutic approach for post-ESD pyloric stenosis.

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内镜下粘膜剥离治疗幽门肿瘤的疗效和安全性。

背景和目的：尽管幽门病变的内镜切除被广泛接受，但幽门肿瘤的内镜下粘膜剥离（ESD）在技术上仍然具有挑战性。本研究旨在评估ESD治疗幽门肿瘤的有效性和安全性。方法：回顾性分析2011年6月至2024年8月中山医院内镜中心行幽门肿瘤ESD手术的103例患者。收集临床数据，包括患者人口统计学、手术结果和随访结果。结果：103例中，幽门前肿瘤36例，幽门肿瘤49例，幽门后肿瘤18例。中位病灶大小为31 mm（范围10-85 mm）。与幽门前组和幽门后组相比，幽门后组的手术时间更长（32 min vs. 39 min vs. 46 min, P = 0.029），整体切除率更低（100.0% vs. 95.9% vs. 83.3%, P = 0.026）。没有病人需要转开手术。手术后，幽门前组和幽门组各1例发生迟发性出血。在中位随访25个月（范围6-81个月）期间，仅有1例复发（幽门组）。5例患者发生esd后幽门狭窄，均通过内镜下球囊扩张术（EBD）获得症状缓解，无并发症。结论：ESD是一种安全可行的治疗幽门肿瘤的方法。此外，EBD似乎是一种安全有效的治疗esd后幽门狭窄的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical Endoscopy And Other Interventional Techniques 医学-外科

CiteScore

6.10

自引率

12.90%

发文量

890

审稿时长

6 months

期刊介绍： Uniquely positioned at the interface between various medical and surgical disciplines, Surgical Endoscopy serves as a focal point for the international surgical community to exchange information on practice, theory, and research. Topics covered in the journal include: -Surgical aspects of: Interventional endoscopy, Ultrasound, Other techniques in the fields of gastroenterology, obstetrics, gynecology, and urology, -Gastroenterologic surgery -Thoracic surgery -Traumatic surgery -Orthopedic surgery -Pediatric surgery