Department of Gastroenterology, Yamashita Hospital, Ichinomiya, Japan.
Department of Pathology, Yamashita Hospital, Ichinomiya, Japan.
Gastrointest Endosc. 2018 Jun;87(6):1576-1580. doi: 10.1016/j.gie.2018.01.015. Epub 2018 Jan 17.
The feasibility of magnetic anchor-guided endoscopic submucosal dissection (MAG-ESD) using a neodymium magnet for gastric lesions has not been clarified. The aim of study was to evaluate the feasibility of MAG-ESD using neodymium magnets while treating gastric lesions.
This prospective trial was conducted at the Yamashita Hospital. MAG-ESD was performed for 50 gastric lesions using an insulated-tip knife. The magnetic anchor consisted of an internal neodymium magnet attached to a hemoclip with 3-0 silk. The external and internal magnets were made from the neodymium magnet. The feasibility of traction using MAG-ESD, en bloc resection rate, complete en bloc resection rate, time required for preparation and attaching the magnetic anchor, procedure time, rate of retrieval of the magnetic anchors, and adverse events were evaluated.
Fifty patients (median lesion size, 20 mm [range, 5-100]) were enrolled. MAG-ESDs were successfully performed for all 50 gastric lesions. Adequate counter-traction was obtained using the external magnet. En bloc resections were achieved and complete en bloc resections confirmed in all cases without adverse events. Attaching the magnetic anchor required a median of 6 minutes (range, 2-14). The median procedure time was 49 minutes (range, 15-301), and the magnetic anchors could be retrieved in all cases.
This study clearly demonstrated the feasibility of this MAG-ESD in the stomach. We hope this procedure will facilitate the resection of difficult lesions. (Clinical trial registration number: UMIN000024100.).
使用钕磁铁进行磁锚引导内镜黏膜下剥离术（MAG-ESD）治疗胃病变的可行性尚未明确。本研究旨在评估使用钕磁铁进行 MAG-ESD 治疗胃病变的可行性。
本前瞻性试验在山下医院进行。使用绝缘刀头对 50 个胃病变进行 MAG-ESD。磁锚由附有 3-0 丝线的止血夹固定的内置钕磁铁组成。内外磁铁均由钕磁铁制成。评估了使用 MAG-ESD 进行牵引的可行性、整块切除率、完全整块切除率、准备和附着磁锚所需的时间、手术时间、磁锚回收率以及不良事件。
50 例患者（中位病变大小 20mm[范围，5-100]）入选。所有 50 个胃病变均成功进行了 MAG-ESD。使用外部磁铁可获得足够的反牵引力。所有病例均获得整块切除，且均证实完全整块切除，无不良事件发生。附着磁锚需要中位数 6 分钟（范围，2-14 分钟）。中位手术时间为 49 分钟（范围，15-301 分钟），所有病例均可回收磁锚。
本研究清楚地表明了这种 MAG-ESD 在胃中的可行性。我们希望该手术程序将有助于切除困难的病变。（临床试验注册号：UMIN000024100.）。
