THE ROLE OF ENDOSCOPIC SUBMUCOSAL DISSECTION IN THE MANAGEMENT OF GASTRIC INFLAMMATORY FIBROID POLYPS: A SINGLE-CENTER EXPERIENCE

Aims To evaluate safety and effectiveness of endoscopic submucosal dissection in the management of gastric inflammatory fibroid polyps not amenable to resection with snare polypectomy.

Methods A retrospective observational study of all consecutive patients who undergone endoscopic submucosal dissection for gastric inflammatory fibroid polyps between January 2011 and December 2020 was performed.

Results There were 9 cases of gastric inflammatory fibroid polyps resected by endoscopic submucosal dissection. Most patients were female (7/9) with mean age of 62.2 years. Most patients (5/9) were symptomatic and reported dyspepsia (4/9) or vomiting (1/9). All gastric inflammatory fibroid polyps were described as solitary antral subepithelial lesions with mean diameter of 16.7 mm that, at endoscopic ultrasound, appeared well-circumscribed and homogeneous lesions located at muscularis mucosa and submucosa without deeper invasion. All lesions were successfully resected en-bloc and complete resection with free margins was obtained in 8/9 specimens. Adverse events were reported in 2/9 cases including one intra-procedural bleeding successfully controlled with hemostatic clips and one aspiration pneumonia that evolved favorably. Mean follow-up duration was 33.7 months (range 3–120) and no delayed complications or cases of recurrence were detected during this period.

Conclusions Endoscopic submucosal dissection appears safe and effective for resection of gastric inflammatory fibroid polyps that present as large subepithelial lesions, if performed by experienced endoscopists after adequate characterization by endoscopic ultrasound, with high rates of technical success and low recurrence rates.

Publication History

Article published online:
14 April 2022