Luo Shao-Bin, Liu Zu-Qiang, Wang Li, Zhang Yi-Qun, Cai Ming-Yan, Li Quan-Lin, Zhou Ping-Hong
Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Shanghai Collaborative Innovation Center of Endoscopy, Shanghai, 200032, China.
Surg Endosc. 2025 Sep 16. doi: 10.1007/s00464-025-12061-0.
Although endoscopic resection is widely accepted for pyloric lesions, endoscopic submucosal dissection (ESD) of pyloric neoplasms remains technically challenging. The study aimed to assess the efficacy and safety of ESD for pyloric neoplasms.
From June 2011 to August 2024, we retrospectively analyzed 103 patients with pyloric neoplasms who underwent ESD at the Endoscopy Center of Zhongshan Hospital. Clinical data, including patient demographics, procedural outcomes, and follow-up results, were collected.
Among 103 lesions, there were 36 prepyloric neoplasms, 49 pyloric neoplasms and 18 postpyloric neoplasms. The median lesion size was 31 mm (range 10-85 mm). The postpyloric group showed longer procedure duration (32 min vs. 39 min vs. 46 min, P = 0.029) and lower rate of en bloc resection (100.0% vs. 95.9% vs. 83.3%, P = 0.026) compared with the prepyloric group and pyloric group. No patients required conversion to open surgery. After procedure, delayed bleeding occurred in one patient each from the prepyloric and pyloric groups. During a median follow-up of 25 months (range: 6-81 months), only one recurrence (pyloric group) was observed. Post-ESD pyloric stenosis developed in 5 patients, all of whom achieved symptomatic relief through endoscopic balloon dilation (EBD) without complications.
ESD is a feasible and safe treatment for pyloric neoplasms. Additionally, EBD appears to be a safe and effective therapeutic approach for post-ESD pyloric stenosis.
尽管内镜切除术已被广泛应用于幽门病变，但幽门肿瘤的内镜黏膜下剥离术（ESD）在技术上仍具有挑战性。本研究旨在评估ESD治疗幽门肿瘤的疗效和安全性。
回顾性分析2011年6月至2024年8月在中山医院内镜中心接受ESD治疗的103例幽门肿瘤患者的临床资料，包括患者人口统计学信息、手术结果及随访结果。
103个病变中，有36个幽门前肿瘤、49个幽门肿瘤和18个幽门后肿瘤。病变的中位大小为31mm（范围10 - 85mm）。与幽门前组和幽门组相比，幽门后组的手术时间更长（32分钟 vs. 39分钟 vs. 46分钟，P = 0.029），整块切除率更低（100.0% vs. 95.9% vs. 83.3%，P = 0.026）。无患者需要转为开放手术。术后，幽门前组和幽门组各有1例患者发生延迟出血。在中位随访25个月（范围：六个月至81个月）期间，仅观察到1例复发（幽门组）。5例患者发生ESD术后幽门狭窄，所有患者均通过内镜球囊扩张术（EBD）获得症状缓解，且无并发症发生。
ESD是治疗幽门肿瘤的一种可行且安全的方法。此外，EBD似乎是治疗ESD术后幽门狭窄的一种安全有效的治疗方法。
