The role of endoscopic submucosal dissection in the management of gastric inflammatory fibroid polyps: a single-center experience

ABSTRACT

Background and aim: gastric inflammatory fibroid polypsconstitute only 0.1 % of all gastric polyps. They are usually amenable to resection by snare polypectomy. However,on rare occasions, these lesions may require resection byendoscopic submucosal dissection. This study aimed toevaluate the effectiveness and safety of endoscopic submucosal dissection in the management of gastric inflammatory fibroid polyps not amenable to resection with snarepolypectomy.Methods: a retrospective observational study of all consecutive patients who underwent endoscopic submucosaldissection for gastric inflammatory fibroid polyps betweenJanuary 2011 and December 2020 was performed.Results: there were nine cases of gastric inflammatoryfibroid polyps resected by endoscopic submucosal dissection. Most patients were female (7/9) with a mean ageof 62.2 years. All gastric inflammatory fibroid polyps weredescribed as solitary antral subepithelial lesions with amean diameter of 16.7 mm, which appeared well-circumscribed and homogeneous lesions located at muscularismucosa and submucosa without deeper invasion on endoscopic ultrasound. All lesions were successfully resected byen bloc and complete resection with free margins obtainedin 8/9 specimens. Adverse events were reported in 2/9 casesincluding one intra-procedural bleeding successfully controlled with hemostatic clips and one aspiration pneumonia that evolved favorably. Mean follow-up duration was 33.7 months and no delayed complications or cases ofrecurrence were reported.Conclusions: endoscopic submucosal dissection appearssafe and effective for the resection of gastric inflammatoryfibroid polyps that present as large subepithelial lesions,if performed by experienced endoscopists after adequatecharacterization by endoscopic ultrasound, with high ratesof technical success and low recurrence rates. (AU)