The efficacy of full-thickness endoscopic resection of subepithelial tumors in the gastric cardia  

作　　者：En-Pan Xu Zhi-Peng Qi Bing Li Zhong Ren Ming-Yan Cai Shi-Lun Cai Zhen-Tao Lyv Zhang-Han Chen Jing-Yi Liu Qiang Shi Yun-Shi Zhong 

机构地区：[1]Endoscopy Center,Zhongshan Hospital Fudan University,Shanghai 200032,China

出　　处：《World Journal of Gastrointestinal Oncology》2023年第12期2111-2119,共9页世界胃肠肿瘤学杂志（英文版）（电子版）

基　　金：Supported by National Natural Science Foundation of China,No.82273025;China Postdoctoral Science Foundation,No.2022TQ0070 and No.2022M710759;Shanghai Municipal Commission of Science and Technology,No.22JC1403003 and No.22S31903800.

摘　　要：BACKGROUND Gastric subepithelial tumors(SETs)may harbor potential malignancy.Although it is well recognized that large SETs should be resected,the precise treatment strategy remains controversial.Compared to surgical resection,endoscopic resection(ER)has many advantages;however,ER of SETs in the cardia is challenging.AIM To evaluate the safety and efficacy of endoscopic full-thickness resection(EFTR)for the treatment of gastric cardia SETs.METHODS We retrospectively reviewed data from all patients with SETs originating from the muscularis propria layer in the gastric cardia that were treated by EFTR or submucosal tunneling ER(STER)at Zhongshan Hospital Fudan University between November 2014 and May 2022.Baseline characteristics and clinical outcomes,including procedure times and complications rates,were compared between groups of patients receiving EFTR and STER.RESULTS A total of 171 tumors were successfully removed[71(41.5%)tumors in the EFTR and 100(58.5%)tumors in the STER group].Gastrointestinal stromal tumors(GISTs)were the most common SET.The en bloc resection rate was 100%in the EFTR group vs 97.0%in STER group(P>0.05).Overall,the EFTR group had a higher complete resection rate than the STER group(98.6%vs 91.0%,P<0.05).The procedure time was also shorter in the EFTR group(44.63±28.66 min vs 53.36±27.34,P<0.05).The most common major complication in both groups was electrocoagulation syndrome.There was no significant difference in total complications between the two groups(21.1%vs 22.0%,P=0.89).CONCLUSION EFTR of gastric cardia SETs is a very promising method to facilitate complete resection with similar complications and reduced operative times compared to STER.In cases of suspected GISTs or an unclear diagnosis,EFTR should be recommended to ensure complete resection.

关 键 词：Endoscopic full-thickness resection Submucosal tunneling endoscopic resection Gastrointestinal stromal tumor Gastric cardia Gastric subepithelial tumors 

分 类 号：R735[医药卫生—肿瘤]