Heterotopic gastric mucosa in the anus and rectum:first case report of endoscopic submucosal dissection and systematic review

作     者：Federico Iacopini Takuji Gotoda Walter Elisei Patrizia Rigato Fabrizio Montagnese Yutaka Saito Guido Costamagna Giampaolo Iacopini 

作者机构：Gastroenterology and Endoscopy UnitOspedale S.GiuseppeAlbano L.RomeItaly Division of Gastroenterology and HepatologyNihon University School of MedicineTokyoJapan Pathology UnitOspedale S.GiuseppeMarinoItaly Endoscopy DivisionNational Cancer Center HospitalTokyoJapan Digestive Endoscopy UnitPoliclinico GemelliCatholic UniversityRomeItaly Gastroenterology ClinicRomeItaly 

出 版 物：《Gastroenterology Report》 (胃肠病学报道（英文）)

年 卷 期：2016年第4卷第3期

页      面：196-205,I0001页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：We thank Mrs.Christel Strohn and Mrs.Sara Piazza for their assistance in German translation.Author contributions:GI designed the research FI and GI performed the research TG YS and GC critically reviewed the final version of the paper and GI and FI wrote the paper 

主　　题：heterotopic gastric mucosa endoscopic submucosal dissection review rectum 

摘      要：Background:Heterotopic gastric mucosa(HGM)is the most reported epithelial heterotopia,but it is very rare in the rectum and ***:The first case of an asymptomatic adult male with a large nonpolypoid HGM in the low rectum underwent complete resection by endoscopic submucosal dissection(ESD)is *** systematic review was based on a comprehensive search of MEDLINE,EMBASE and Google *** on humans were identified with the term‘heterotopic gastric mucosa in the rectum and/or anus.’Results:The search identified 79 citations,and 72 cases were evaluated comprising the present *** malformations were observed in 17(24%)patients;rectal duplication accounted for most of the *** HGM was located in the anus and perineal rectum in 25 cases(41%)and low,middle and proximal pelvic rectum in 20(33%),five(8%)and 11 cases(18%),*** was nonpolypoid in 37 cases(51%),polypoid in 26 cases(36%)and ulcerated in nine cases(13%).Specific anorectal symptoms were reported by 50(69%)patients of the whole study population,and by 33(97%)of 34 patients≤18 *** were observed in 23 cases(32%).The HGM was excised in 50 cases(83%).Endoscopic resection was performed in 17 cases(34%);resection was piecemeal in five of 12 lesions≥5mm,required argon plasma coagulation in two cases and was associated with residual tissue in two(17%).Intestinal metaplasia and an adenoma with lowgrade dysplasia were described in three adults(4%).Discussion:This systematic review shows that the HGM in the rectum and anus may be associated with specific rectal symptoms and serious complications,mainly in the pediatric population,and a risk of malignancy in *** complete excision should be recommended,and the ESD can overcome the technical limits of conventional endoscopic snare resection and avoid unnecessary surgery.