Akahoshi Kazuya, Inamura Kazuki, Akahoshi Kazuaki, Osada Shigeki, Tamura Shinichi, Oishi Yoshihiro, Oya Masafumi, Koga Hidenobu
Endoscopy Center, Aso Iizuka Hospital, Iizuka, Japan.
Department of Gastroenterology, Aso Iizuka Hospital, Iizuka, Japan.
Clin Endosc. 2025 Mar;58(2):278-284. doi: 10.5946/ce.2024.094. Epub 2024 Oct 10.
BACKGROUND/AIMS: The efficacy and safety of endoscopic submucosal dissection using a clutch cutter (ESD-CC) for subepithelial lesions within the esophagogastric submucosa (SELEGSM) has not been investigated. This study aimed to assess the efficacy and safety of ESD-CC for the treatment of SELEGSM.
This prospective study included 15 consecutive patients with 18 SELEGSMs diagnosed by endoscopic ultrasonography. The primary outcomes were short-term outcomes including en bloc resection rate, R0 resection rate, procedure time, and complication rate. The secondary outcome was final histological diagnosis.
Among the participants, 18 lesions were identified: 12 in the stomach (nine patients) and six in the esophagus (six patients). The en bloc resection rate was 94.4% (17/18). The R0 resection rate was 88.9% (16/18). The median operating time was 39 min, and no instances of perforation or bleeding were observed. The final diagnoses of SELEGSM included six neuroendocrine tumors (33.3%), six granular cell tumors (33.3%), two ectopic pancreases (11.1%), one inflammatory fibroid polyp (5.6%), one leiomyoma (5.6%), one lipoma (5.6%), and one leiomyosarcoma (5.6%).
ESD-CC appears to be a technically efficient and safe approach for SELEGSM resection, suggesting its potential as a valuable treatment option.
背景/目的:尚未研究使用离合切割器的内镜黏膜下剥离术(ESD-CC)治疗食管胃黏膜下层上皮下病变(SELEGSM)的有效性和安全性。本研究旨在评估ESD-CC治疗SELEGSM的有效性和安全性。
这项前瞻性研究纳入了15例经内镜超声诊断为18处SELEGSM的连续患者。主要结局为短期结局,包括整块切除率、R0切除率、手术时间和并发症发生率。次要结局为最终组织学诊断。
在参与者中,共识别出18处病变:12处位于胃(9例患者),6处位于食管(6例患者)。整块切除率为94.4%(17/18)。R0切除率为88.9%(16/18)。中位手术时间为39分钟,未观察到穿孔或出血情况。SELEGSM的最终诊断包括6例神经内分泌肿瘤(33.3%)、6例颗粒细胞瘤(33.3%)、2例异位胰腺(11.1%)、1例炎性纤维息肉(5.6%)、1例平滑肌瘤(5.6%)、1例脂肪瘤(5.6%)和1例平滑肌肉瘤(5.6%)。
ESD-CC似乎是一种技术上有效且安全的SELEGSM切除术方法,表明其作为一种有价值的治疗选择的潜力。