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Clinical outcomes of endoscopic resection for gastric neoplasms in the pylorus

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Abstract

Background

Endoscopic resection for gastric neoplasms in the pylorus is a technically difficult procedure. We investigated clinical outcomes to determine the feasibility and effectiveness of endoscopic resection for gastric neoplasms in the pylorus.

Methods

Subjects who underwent endoscopic resection for gastric neoplasms in the pylorus between January 1997 and February 2012 were eligible.

Results

A total of 227 subjects underwent endoscopic resection for 228 gastric adenomas and early cancers in the pylorus. En bloc resection was achieved for 193 lesions (84.6 %), including complete resection of 195 lesions (85.5 %), and curative resection of 167 lesions (73.2 %). Complete resection and curative resection rates were significantly different according to the location (prepyloric, pyloric, and postpyloric, P = 0.002 and P = 0.006). Delayed bleeding and stricture occurred in 5.3 and 3.1 %, respectively, and there was no patient with perforation. During a median follow-up period of 79.0 months, local tumor recurrence was detected in 2.6 %.

Conclusions

Endoscopic resection appears to be a feasible and effective method for the treatment of pyloric neoplasms, regardless of the location and distribution of tumor. Thorough evaluation of the distal margin of the tumors is necessary when tumors involve or extend beyond the pyloric ring, and the appropriate use of additional techniques may be useful.

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Disclosures

Eun Jeong Gong, Do Hoon Kim, Hwoon-Yong Jung, Young Kwon Choi, Hyun Lim, Kwi-Sook Choi, Ji Yong Ahn, Jeong Hoon Lee, Kee Don Choi, Ho June Song, Gin Hyug Lee, and Jin-Ho Kim declare no potential conflicts of interest.

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Author notes

    Authors and Affiliations

    1. Department of Gastroenterology, Asan Medical Center, Asan Digestive Disease Research Institute, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea

      Eun Jeong Gong, Do Hoon Kim, Hwoon-Yong Jung, Young Kwon Choi, Kwi-Sook Choi, Ji Yong Ahn, Jeong Hoon Lee, Kee Don Choi, Ho June Song, Gin Hyug Lee & Jin-Ho Kim

    2. Department of Gastroenterology, Hallym University Sacred Heart Hospital, Anyang, Korea

      Hyun Lim

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    1. Eun Jeong Gong
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    2. Do Hoon Kim
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    4. Young Kwon Choi
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    5. Hyun Lim
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    Correspondence to Do Hoon Kim.

    Additional information

    Eun Jeong Gong and Do Hoon Kim have contributed equally to this study.

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    Cite this article

    Gong, E.J., Kim, D.H., Jung, HY. et al. Clinical outcomes of endoscopic resection for gastric neoplasms in the pylorus. Surg Endosc 29, 3491–3498 (2015). https://doi.org/10.1007/s00464-015-4099-8

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    • DOI: https://doi.org/10.1007/s00464-015-4099-8

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