{"title":"凝胶浸泡内镜下胃粘膜切除术治疗家族性腺瘤性息肉病患者的疗效和安全性：一项多中心回顾性研究","authors":"Hidenori Kimura, Kohei Shigeta, Yohei Yabuuchi, Yoichi Yamamoto, Soichiro Nagao, Akito Noguchi, Shinya Uematsu, Shuhei Shintani, Hiroto Inoue, Atsushi Nishida, Hiroyuki Ono, Osamu Inatomi","doi":"10.1002/deo2.70209","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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%, <i>p</i> = 0.19, respectively). The procedure time was significantly shorter for GI-EMR than for ESD (2 vs. 47 min, <i>p</i> < 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.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>GI-EMR may be considered one of the therapeutic options for GNs in patients with FAP.</p>\n </section>\n </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70209","citationCount":"0","resultStr":"{\"title\":\"Efficacy and Safety of Gel Immersion Endoscopic Mucosal Resection for Gastric Neoplasms in Patients With Familial Adenomatous Polyposis: A Multicenter Retrospective Study\",\"authors\":\"Hidenori Kimura, Kohei Shigeta, Yohei Yabuuchi, Yoichi Yamamoto, Soichiro Nagao, Akito Noguchi, Shinya Uematsu, Shuhei Shintani, Hiroto Inoue, Atsushi Nishida, Hiroyuki Ono, Osamu Inatomi\",\"doi\":\"10.1002/deo2.70209\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>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%, <i>p</i> = 0.19, respectively). The procedure time was significantly shorter for GI-EMR than for ESD (2 vs. 47 min, <i>p</i> < 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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>GI-EMR may be considered one of the therapeutic options for GNs in patients with FAP.</p>\\n </section>\\n </div>\",\"PeriodicalId\":93973,\"journal\":{\"name\":\"DEN open\",\"volume\":\"6 1\",\"pages\":\"\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-09-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70209\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"DEN open\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/deo2.70209\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"DEN open","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/deo2.70209","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
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。
Efficacy and Safety of Gel Immersion Endoscopic Mucosal Resection for Gastric Neoplasms in Patients With Familial Adenomatous Polyposis: A Multicenter Retrospective Study
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.
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