摘要
BACKGROUND Endoscopic submucosal dissection(ESD)is widely accepted for early gastric cancer(EGC)without lymph node metastasis,although ESD is challenging,even for small lesions,in the greater curvature(GC)of the upper(U)and middle(M)thirds of the stomach.Grasping forceps-assisted endoscopic resection(GF-ER)is a type of endoscopic mucosal resection that is performed via a double-channel endoscope.AIM To investigate the safety and efficacy of GF-ER vs ESD in the GC of the stomach’s U and M regions.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.Nine lesions from eight patients who underwent GF-ER for EGC(the GF-ER group)were compared to 63 lesions from 63 patients who underwent ESD(the ESD group).We also performed a subgroup analysis of small lesions(≤10 mm)in 6 patients(7 lesions)from the GF-ER group and 20 patients(20 lesions)from the ESD group.RESULTS There were no statistically significant differences between the GF-ER and ESD groups in the en bloc resection rates(100%vs 100%)and the R0 resection rates(100%vs 98.4%).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).There were no adverse events in the GF-ER group,although 1 case of perforation(1.6%)were observed in the ESD group.CONCLUSION These findings suggest that GF-ER may be an effective therapeutic option for small lesions in the GC of the stomach’s U and M regions.
