Digestion · 2026
Endoscopic treatment strategies for gastric foveolar-type adenoma with a raspberry-like appearance.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Iwano Tomoyo, Suzuki Nobuyuki, Ueyama Hiroya, Nakamura Shunsuke, Uemura Yasuko, Yamamoto Momoko, Abe Daiki, Oki Shotaro, Akazawa Yoichi, Takeda Tsutomu, Ueda Kumiko, Hojo Mariko, Nojiri Shuko, Yao Takashi, Nagahara Akihito
Аннотация
BACKGROUND/OBJECTIVES: Endoscopic treatment strategies for gastric foveolar-type adenoma with a raspberry-like appearance (GFA-R) have not yet been established. We aimed to clarify the efficacy and safety of endoscopic procedures for GFA-R.
METHODS: We extracted GFA-Rs, which were pathologically diagnosed in accordance with WHO classification, at our hospital from January 2009 to December 2023 by endoscopy and retrospectively analyzed their clinicopathological features and endoscopic outcomes.
RESULTS: Eighty-eight GFA-Rs were collected from 74 patients. The mean size of GFA-Rs was 4.2 mm (range, 1-10 mm). All lesions demonstrated intramucosal neoplasms without lymphovascular invasion. Endoscopic procedures included only biopsy (n=6), cold forceps polypectomy (CFP; n=42, as outpatient 38/42), cold snare polypectomy (CSP; n=4), endoscopic mucosal resection (EMR; n=36, as inpatient 36/36). The overall en bloc resection rate was 93.9 % (77/82), with rates of 92.9 % (39/42) for CFP, 75.0 % (3/4) for CSP, and 97.2 % (35/36) for EMR, respectively. Lesions smaller than 5 mm were more often treated with CFP while lesions larger than 5 mm were more often treated with EMR. No complications, such as post-operative bleeding or delayed perforation, occurred regardless of the endoscopic procedure. The mean follow-up period was 28.7 months (range, 2-165 months). No local recurrences occurred at 1 year (9-18 months) after an endoscopic procedure for 62 lesions, 2 years (19-30 months) for 40 lesions, and 3 years (31-42 months) for 24 lesions.
CONCLUSIONS: These results suggest that endoscopic procedures for GFA-R are effective and safe regardless of the procedure used. Moreover, outpatient CFP may be a simple, useful, and cost-effective endoscopic procedure for GFA-R smaller than 5 mm.
METHODS: We extracted GFA-Rs, which were pathologically diagnosed in accordance with WHO classification, at our hospital from January 2009 to December 2023 by endoscopy and retrospectively analyzed their clinicopathological features and endoscopic outcomes.
RESULTS: Eighty-eight GFA-Rs were collected from 74 patients. The mean size of GFA-Rs was 4.2 mm (range, 1-10 mm). All lesions demonstrated intramucosal neoplasms without lymphovascular invasion. Endoscopic procedures included only biopsy (n=6), cold forceps polypectomy (CFP; n=42, as outpatient 38/42), cold snare polypectomy (CSP; n=4), endoscopic mucosal resection (EMR; n=36, as inpatient 36/36). The overall en bloc resection rate was 93.9 % (77/82), with rates of 92.9 % (39/42) for CFP, 75.0 % (3/4) for CSP, and 97.2 % (35/36) for EMR, respectively. Lesions smaller than 5 mm were more often treated with CFP while lesions larger than 5 mm were more often treated with EMR. No complications, such as post-operative bleeding or delayed perforation, occurred regardless of the endoscopic procedure. The mean follow-up period was 28.7 months (range, 2-165 months). No local recurrences occurred at 1 year (9-18 months) after an endoscopic procedure for 62 lesions, 2 years (19-30 months) for 40 lesions, and 3 years (31-42 months) for 24 lesions.
CONCLUSIONS: These results suggest that endoscopic procedures for GFA-R are effective and safe regardless of the procedure used. Moreover, outpatient CFP may be a simple, useful, and cost-effective endoscopic procedure for GFA-R smaller than 5 mm.