Published online Jul 26, 2020. doi: 10.12998/wjcc.v8.i14.3050
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
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.
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.
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.