Efficacy and Safety of Gel Immersion Endoscopic Mucosal Resection for Gastric Neoplasms in Patients With Familial Adenomatous Polyposis: A Multicenter Retrospective Study
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引用次数: 0
Abstract
Objectives
Approximately 10%–30% patients with familial adenomatous polyposis (FAP) develop gastric neoplasms (GNs). Although recent reports have suggested the effectiveness of gel-immersion endoscopic mucosal resection (GI-EMR) for FAP-associated GNs, given its simplicity and safety, treatment outcomes for such lesions have not been evaluated. We aimed to investigate the efficacy and safety of GI-EMR compared with endoscopic submucosal dissection (ESD) for GNs in patients with FAP.
Methods
In this multicenter, retrospective study, treatment outcomes of ESD and GI-EMR for GNs measuring ≤20 mm with protruding or flat elevated morphology between April 2011 and November 2024 were compared.
Results
This study included 15 ESD and 12 GI-EMR cases. En bloc and R0 resection rates did not significantly differ between the ESD and GI-EMR groups (100% vs. 100% and 100% vs. 83.3%, p = 0.19, respectively). The procedure time was significantly shorter for GI-EMR than for ESD (2 vs. 47 min, p < 0.001, respectively). Intraprocedural perforation occurred in 6.7% of ESD cases, but was not observed in the GI-EMR group. Neither delayed bleeding nor perforation occurred in any group. During the median follow-up period of 22.3 months, no local recurrence was observed in either group.
Conclusions
GI-EMR may be considered one of the therapeutic options for GNs in patients with FAP.
目的：大约10%-30%的家族性腺瘤性息肉病（FAP）患者会发展为胃肿瘤（GNs）。尽管最近的报道表明凝胶浸泡内镜粘膜切除术（GI-EMR）治疗fap相关GNs的有效性，但鉴于其简单和安全，此类病变的治疗结果尚未得到评估。我们的目的是比较GI-EMR与内镜下粘膜剥离（ESD）对FAP患者GNs的疗效和安全性。方法采用多中心回顾性研究方法，比较2011年4月至2024年11月对≤20 mm、形态突出或扁平升高的GNs进行ESD和GI-EMR的治疗效果。结果本研究纳入ESD 15例，GI-EMR 12例。整体和R0切除率在ESD组和GI-EMR组之间无显著差异（100% vs 100%和100% vs 83.3%, p = 0.19）。GI-EMR的手术时间明显短于ESD（2分钟vs. 47分钟，p < 0.001）。术中穿孔发生在6.7%的ESD病例中，但在GI-EMR组未观察到。两组均未发生迟发性出血或穿孔。中位随访22.3个月，两组均未见局部复发。结论GI-EMR可作为FAP患者GNs的治疗选择之一。
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