Ichijima R, Suzuki S, Esaki M, Horii T, Kusano C, Ikehara H, Gotoda T. Efficacy and safety of grasping forceps-assisted endoscopic resection for gastric neoplasms: A multi-centre retrospective study. World J Gastrointest Oncol 2021; 13(3): 174-184 [PMID: PMC7953346 DOI: 10.4251/wjgo.v13.i3.174]
Corresponding Author of This Article
Ryoji Ichijima, MD, Doctor, Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 1-6 Kanda-Surugadai, Chiyoda-ku 101-0062, Tokyo, Japan. ryoji0331@yahoo.co.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Ryoji Ichijima, Sho Suzuki, Mitsuru Esaki, Toshiki Horii, Chika Kusano, Hisatomo Ikehara, Takuji Gotoda, Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Chiyoda-ku 101-0062, Tokyo, Japan
Mitsuru Esaki, Department of Medicine and Bioregulatory Sience, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
Toshiki Horii, Department of Gastroenterology, Yuri Kumiai General Hospital, Yurihonjou City 015-8511, Akita, Japan
Author contributions: Ichijima R and Suzuki S drafted and revised the manuscript for important intellectual content; Esaki M and Horii T analysed and interpreted the data; Esaki M, Kusano C, Ikehara H and Gotoda T revised the manuscript for important intellectual content; all authors have read and approved the final version of the manuscript.
Institutional review board statement: The study protocol was approved by the institutional review board of Nihon University Surugadai Hospital.
Informed consent statement: Written informed consent was obtained from the patients before the ESD and GF-ER procedures.
Conflict-of-interest statement: The authors declare that they have no conflict-of-interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ryoji Ichijima, MD, Doctor, Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 1-6 Kanda-Surugadai, Chiyoda-ku 101-0062, Tokyo, Japan. ryoji0331@yahoo.co.jp
Received: December 10, 2020 Peer-review started: December 10, 2020 First decision: December 31, 2020 Revised: January 9, 2021 Accepted: February 1, 2021 Article in press: February 1, 2021 Published online: March 15, 2021 Processing time: 89 Days and 1.1 Hours
ARTICLE HIGHLIGHTS
Research background
Endoscopic submucosal dissection (ESD) is widely accepted for early gastric cancer (EGC), although ESD is challenging, even for small lesions, in the greater curvature (GC) of the upper (U) and middle (M) thirds of the stomach.
Research motivation
Since ESD has become established, no new studies have compared the therapeutic outcomes of grasping forceps-assisted endoscopic resection (GF-ER) and ESD in the challenging U and M stomach regions.
Research objectives
To investigate the safety and efficacy of GF-ER and ESD in the GC of the stomach’s U and M regions.
Research methods
We retrospectively reviewed the medical records of 506 patients who underwent ER of 522 EGC lesions in the stomach’s U and M regions in three institutions between January 2016 and May 2020.
Research results
En bloc resection was achieved in all patients from the GF-ER and ESD groups. The median procedure time in the GF-ER group was shorter than that in the ESD group (4.0 min vs 55.0 min, P < 0.01). There were no adverse events in the GF-ER group, although five perforations (8.0%) and 1 case of postoperative bleeding (1.6%) were observed in the ESD group. When we only considered lesions that were ≤ 10 mm, the median procedure time in the GF-ER group was still shorter than that in the ESD group (4.0 min vs 35.0 min, P < 0.01).
Research conclusions
GF-ER should be considered as an option for lesions in the GC of the stomach’s U and M regions, where ESD is considered a long, technically challenging, and potentially risky procedure.
Research perspectives
A large prospective study is needed to validate our findings.
