Comparing about three types of endoscopic therapy methods for upper gastrointestinal submucosal tumors originating from the muscularis propria layer.
Background: Endoscopic submucosal excavation (ESE), endoscopic full-thickness resection (EFTR) and submucosal tunneling endoscopic resection (STER) have been widely applied to upper gastrointestinal submucosal tumors (SMTs) originating from the muscularis propria (MP) layer in recent years. But until now, there are few studies that comparing the efficacy and safety of three endoscopic therapy methods.Method: From January 2013 to August 2018, a total of 218 patients with SMTs who underwent ESE, EFTR or STER were enrolled in this retrospective study. Clinicopathological characteristics, endoscopic features, complication and follow-up data were analyzed.Result: There were 114 patients underwent ESE, 61 underwent EFTR and 43 underwent STER, respectively. The en bloc and complete resection rates in STER group (83.7% and 90.0%) were significantly lower and postoperative complication rate (62.8%) was significantly higher than those of the other 2 methods. Furthermore, for lesions <40 mm, no significant differences were found in the en bloc rate, complete rate and postoperative complication rate among 3 methods. The perforation rate decreased in the order of EFTR (100%), ESE (23.7%), STER (7.0%). The median number of clips, fasting time and hospital stay were lowest in ESE group (5, 2 days, and 7 days). And the cost was highest in EFTR group ($4993.1). There were no differences in the bleeding and recurrence rates among three groups.Conclusion: For SMTs <40 mm, the efficacy among 3 ER methods are comparative. The choice of ER methods mainly based on the comprehensive consideration of lesion size, location, growth pattern and clinical experience of endoscopists. For benign SMTs ≥40 mm in stomach, ESE and EFTR becomes alternative choices.
['Xiu|Hui|H|', 'Zhao|Cheng-Ye|CY|', 'Liu|Fu-Guo|FG|', 'Sun|Xue-Guo|XG|', 'Sun|Hui|H|', 'Liu|Xi-Shuang|XS|']
D002681:China D000069916:Endoscopic Mucosal Resection D000071041:Esophageal Mucosa D004938:Esophageal Neoplasms D004945:Esophagoscopy D005260:Female D005753:Gastric Mucosa D005773:Gastroscopy D006801:Humans D007431:Intraoperative Complications D007902:Length of Stay D008297:Male D008875:Middle Aged D010043:Outcome and Process Assessment, Health Care D011183:Postoperative Complications D013274:Stomach Neoplasms
submucosal tumors Endoscopic submucosal excavation endoscopic full-thickness resection submucosal tunneling endoscopic resection