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A Practical Endoscopic Treatment Strategy for Appendiceal Orifice Lesions Using Forceps-Assisted Polypectomy (Strip
Toshifumi Iida1, Jun Arimoto1, Ai Hirohata1
1Department of Gastroenterology, Omori Red Cross Hospital, 4-30-1 Chuo, Ota-ku, Tokyo, 143-8527, Japan.
Digestive Diseases and Sciences
|July 24, 2026
Summary
Strip biopsy offers a faster endoscopic treatment for small appendiceal orifice lesions compared to endoscopic submucosal dissection (ESD). This method is effective, though further research is needed.
Area of Science:
- Gastroenterology
- Endoscopic Surgery
- Oncology
Background:
- Endoscopic treatment of appendiceal orifice lesions presents technical challenges.
- Endoscopic submucosal dissection (ESD) allows en bloc resection but may be overtreatment.
- Forceps-assisted strip biopsy is a potential alternative therapy.
Purpose of the Study:
- To propose a practical treatment strategy for appendiceal orifice lesions.
- To evaluate the clinical usefulness and feasibility of strip biopsy.
Main Methods:
- Retrospective single-center study of patients with appendiceal orifice lesions (May 2017-September 2025).
- Patients were divided into strip biopsy or ESD groups.
- Procedural outcomes and adverse events were compared between groups.
Main Results:
- 14 lesions treated with strip biopsy, 8 with ESD; comparable baseline characteristics.
- Strip biopsy group had significantly shorter procedure times (6.6 vs. 45.9 min).
- En bloc resection rates were high (93% strip biopsy, 100% ESD); no perforations, minimal bleeding.
Conclusions:
- Strip biopsy is a feasible and rapid option for selected small appendiceal orifice lesions without malignant features.
- Larger prospective studies with longer follow-up are necessary due to retrospective design and small sample size.
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