Comparison between submucosal tunneling endoscopic resection and endoscopic full-thickness resection for gastric stromal tumors originating from the muscularis propria layer

Surg Endosc. 2017 Aug;31(8):3376-3382. doi: 10.1007/s00464-016-5350-7. Epub 2016 Nov 18.

Abstract

Background: Both submucosal tunneling endoscopic resection (STER) and endoscopic full-thickness resection (EFTR) are effective method for treating gastric gastrointestinal stromal tumors (GISTs); however, little is known about the comparison between STER and EFTR. The aim of the study was to compare the safety and efficacy of STER and EFTR for treating gastric GIST.

Methods: We retrospectively collected the clinical data about patients with gastric GISTs who received STER or EFTR at our hospital from April 2011 to June 2016. Epidemiological data (gender, age), tumor size, procedure-related parameters, complications, length of stay, cost and follow-up data were compared between STER and EFTR.

Results: A total of 52 patients were enrolled, and 20 of them received STER, while the other 32 cases received EFTR. There was no significant difference between the two groups in terms of gender, age, concomitant diseases, tumor size, en bloc resection rate, operation time, complications, pathohistological grade of GIST, hospital stay and cost (P > 0.05). However, patients who received EFTR had a longer suture time and needed more clips to close the gastric-wall defect (STER vs EFTR, 291.5 ± 68.7 vs 380.6 ± 96.9s and 6.0 ± 1.2 vs 7.6 ± 1.6, P < 0.05). No recurrence was noted in the STER and EFTR groups during a mean follow-up of 10.9 and 23.8 months, respectively.

Conclusions: The treatment efficacy between STER and EFTR for treating gastric GISTs was comparable, and a large-scale, randomized study is necessary for a more confirmed conclusion.

Keywords: Endoscopic full-thickness resection; Gastric submucosal tumor; Gastrointestinal stromal tumor; Submucosal tunneling endoscopic resection.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • China
  • Female
  • Gastrointestinal Stromal Tumors / surgery*
  • Gastroscopy / methods*
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / surgery*
  • Retrospective Studies
  • Stomach Neoplasms / surgery*
  • Surgical Instruments
  • Treatment Outcome