Background and Aims

The feasibility of magnetic anchor–guided endoscopic submucosal dissection (MAG-ESD) using a neodymium magnet for gastric lesions has not been clarified. The aim of study was to evaluate the feasibility of MAG-ESD using neodymium magnets while treating gastric lesions.

Methods

This prospective trial was conducted at the Yamashita Hospital. MAG-ESD was performed for 50 gastric lesions using an insulated-tip knife. The magnetic anchor consisted of an internal neodymium magnet attached to a hemoclip with 3-0 silk. The external and internal magnets were made from the neodymium magnet. The feasibility of traction using MAG-ESD, en bloc resection rate, complete en bloc resection rate, time required for preparation and attaching the magnetic anchor, procedure time, rate of retrieval of the magnetic anchors, and adverse events were evaluated.

Results

Fifty patients (median lesion size, 20 mm [range, 5-100]) were enrolled. MAG-ESDs were successfully performed for all 50 gastric lesions. Adequate counter-traction was obtained using the external magnet. En bloc resections were achieved and complete en bloc resections confirmed in all cases without adverse events. Attaching the magnetic anchor required a median of 6 minutes (range, 2-14). The median procedure time was 49 minutes (range, 15-301), and the magnetic anchors could be retrieved in all cases.

Conclusions

This study clearly demonstrated the feasibility of this MAG-ESD in the stomach. We hope this procedure will facilitate the resection of difficult lesions. (Clinical trial registration number: UMIN000024100.)

中文翻译：

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电磁锚引导下胃镜下黏膜下剥离术治疗胃部病变（带视频）

背景和目标

尚不清楚使用钕磁铁的磁力锚引导的内镜下黏膜下剥离术（MAG-ESD）的可行性。研究的目的是评估钕磁铁在治疗胃部病变时进行MAG-ESD的可行性。

方法

这项前瞻性试验在山下医院进行。使用绝缘尖刀对50个胃部病变进行MAG-ESD。磁性锚钉由内部钕磁铁组成，该磁铁与3-0丝绸的止血夹相连。外部和内部磁体由钕磁体制成。评估了使用MAG-ESD牵引的可行性，整体切除率，完整整体切除率，准备和连接磁性锚钉所需的时间，手术时间，磁性锚钉的取出速率以及不良事件。

结果

入选了50例患者（中位病变大小，20 mm [范围，5-100]）。对所有50个胃部病变均成功进行了MAG-ESD。使用外部磁体可获得足够的反牵引力。在所有病例中均实现了整块切除，并确认了完整的整块切除，且未发生不良事件。连接电磁锚的时间平均为6分钟（范围2-14）。中位手术时间为49分钟（范围为15-301），并且在所有情况下均可以收回磁性锚钉。

结论

这项研究清楚地证明了这种MAG-ESD在胃中的可行性。我们希望该程序将有助于切除困难的病灶。（临床试验注册号：UMIN000024100。）