Department of Gastroenterology, Asahi General Hospital, Chiba, Japan.
Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan.
Endoscopy. 2023 Mar;55(3):261-266. doi: 10.1055/a-1924-4711. Epub 2022 Aug 15.
Although gel immersion endoscopic resection (GIER) is a potential alternative to underwater endoscopic mucosal resection (UEMR) for superficial nonampullary duodenal epithelial tumors (SNADETs), comparisons between the two are currently insufficient.
40 consecutive procedures performed in 35 patients were retrospectively reviewed; the primary outcome was procedure time, and the secondary outcomes were en bloc and R0 resection rates, tumor and specimen size, and adverse events.
Lesions were divided into GIER (n = 22) and UEMR groups (n = 18). The median (range) procedure time was significantly shorter in the GIER group than in the UEMR group (2.75 [1-3.5] minutes vs. 3 2 3 4 5 6 7 8 9 10 minutes; = 0.01). The en bloc resection rate was 100 % in the GIER group, but only 83.3 % in the UEMR group. The R0 resection rate was significantly higher in the GIER group than in the UEMR group (95.5 % vs. 66.7 %; = 0.03). The median specimen size was larger in the GIER group than in the UEMR group (14 mm vs. 7.5 mm; < 0.001). The tumor size was not significantly different between the groups and no adverse events were observed.
GIER is efficacious and safe to treat SNADETs, although additional studies are needed.
尽管胶冻内镜下切除术（GIER）是一种有潜力的替代水下内镜黏膜切除术（UEMR）治疗非壶腹性十二指肠上皮肿瘤（SNADETs）的方法，但目前两者的比较还不够充分。
回顾性分析了 35 例患者的 40 例连续手术；主要结果是手术时间，次要结果是整块和 R0 切除率、肿瘤和标本大小以及不良事件。
病变分为 GIER（n = 22）和 UEMR 组（n = 18）。GIER 组的手术时间明显短于 UEMR 组（2.75 [1-3.5]分钟比 3 2 3 4 5 6 7 8 9 10 分钟； = 0.01）。GIER 组整块切除率为 100%，而 UEMR 组仅为 83.3%。GIER 组 R0 切除率明显高于 UEMR 组（95.5%比 66.7%； = 0.03）。GIER 组标本大小中位数大于 UEMR 组（14 毫米比 7.5 毫米； < 0.001）。两组肿瘤大小无显著差异，均未发生不良事件。
尽管还需要更多的研究，但 GIER 治疗 SNADETs 是有效和安全的。
