Kim DH, Park SY, Park CH, Kim HS, Choi SK. Underwater endoscopic mucosal resection for neoplasms in the pyloric ring of the stomach: Four case reports. World J Clin Cases 2020; 8(14): 3050-3056 [PMID: 32775386 DOI: 10.12998/wjcc.v8.i14.3050]
Corresponding Author of This Article
Seon-Young Park, MD, PhD, Professor, Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, 42 Jaebong-ro, Donggu, Gwangju, 61469, South Korea. drpsy@naver.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
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/
World J Clin Cases. Jul 26, 2020; 8(14): 3050-3056 Published online Jul 26, 2020. doi: 10.12998/wjcc.v8.i14.3050
Underwater endoscopic mucosal resection for neoplasms in the pyloric ring of the stomach: Four case reports
Dong Hyun Kim, Seon-Young Park, Chang Hwan Park, Hyun Soo Kim, Sung Kyu Choi
Dong Hyun Kim, Seon-Young Park, Chang Hwan Park, Hyun Soo Kim, Sung Kyu Choi, Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju 61469, South Korea
Author contributions: Kim DH and Park SY conceived and designed the study, reviewed the literature, and contributed to manuscript drafting; Park CH and Kim HS contributed to manuscript drafting; Choi SK reviewed the cases and edited the manuscript; all authors issued final approval for the version to be submitted; all authors approved the manuscript for publication.
Supported byChonnam National University Hospital Biomedical Research Institute, No. BCRI 20004.
Informed consent statement: Written informed consent was obtained from the patients for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
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: Seon-Young Park, MD, PhD, Professor, Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, 42 Jaebong-ro, Donggu, Gwangju, 61469, South Korea. drpsy@naver.com
Received: April 3, 2020 Peer-review started: April 3, 2020 First decision: April 22, 2020 Revised: May 1, 2020 Accepted: July 15, 2020 Article in press: July 15, 2020 Published online: July 26, 2020 Processing time: 112 Days and 4.5 Hours
Abstract
BACKGROUND
Tumors located in the pylorus are technically more complex to resect by endoscopic resection, as the anatomical characteristics of this region can affect the adequate assessment of margins and performance of the procedure. We reported the results of underwater endoscopic mucosal resection (UEMR) of benign mucosal neoplasms located in the pyloric ring.
CASE SUMMARY
This case series describes 4 patients with 4 mucosal neoplasms located in the pyloric ring. The diameter of each neoplasm was less than 15 mm. We performed UEMR for the lesions. Water immersion enabled slight floating of the lesions, resulting in easy identification. We achieved en bloc resection with a snare and electrosurgical unit. All procedure were performed within 3 min without adverse events. Pathologic examination showed low-grade dysplasia with clear resection margins in one case and hyperplastic polyps in three cases.
CONCLUSION
UEMR can be an effective and safe treatment method for neoplasms in the gastric pyloric ring.
Core tip: We present four patients who underwent underwater endoscopic mucosal resection (UEMR) for the resection of neoplasms in the pyloric ring. UEMR for neoplasms in the pyloric ring has benefits similar to those of UEMR for colonic neoplasms: (1) Superficial lesions float into the snare as protruding lesions in underwater conditions; (2) UEMR decreases thermal damage; (3) Submucosal vessels usually remain within the resection wound, as the resection plane is superficial; and (4) The pyloric narrow lumen is constantly distended, retaining enough working space. Our case series suggested the potential of UEMR for treating neoplasms in the pyloric ring.
