Submucosal Tunneling Endoscopic Resection for Gastric Submucosal Tumors: a Comparison Between Cardia and Non-cardia Location
- 73 Downloads
Background and Purpose
Submucosal tunneling endoscopic resection (STER) was initially used to remove submucosal tumors (SMTs) located at the esophagus and cardia; only few researchers have reported the feasibility of STER for gastric SMTs beyond cardia due to the technical difficulty, and little is known about the comparison of STER for cardia and non-cardia gastric SMTs. The purpose was to compare the feasibility and efficacy of STER for cardia and non-cardia gastric SMTs, as well as to explore the risk factors for failure of en bloc resection.
We retrospectively collected the clinical data about patients with gastric SMTs who received STER at our hospital from June 2012 to June 2018. Demographics, tumor size, procedure-related parameters, complications, hospital stay, and follow-up data were compared between cardia and non-cardia SMTs. And multivariate analyses were conducted to look for the risk factors for failure of en bloc resection.
A total of 46 SMTs were removed, and 25 of them were located at cardia, while the other 21 at non-cardia position. There was no significant difference between the two groups in terms of gender, age, tumor size, en bloc resection rate, operation time, complications, and hospital stay (p > 0.05). No recurrence was noticed in all the cases. Multivariate analyses revealed that irregular shape was an independent risk factor for failure of en bloc resection.
STER is feasible for both cardia and non-cardia gastric SMTs, and the efficacy between cardia and non-cardia location is comparable. Irregular shape was an independent risk factor for failure of en bloc resection.
KeywordsSubmucosal tunneling endoscopic resection Gastric submucosal tumors Endoscopic gastrointestinal surgery Efficacy En bloc resection
This study was funded by Development and Reform Commission of Hunan Province (XFGTZ2014713).
Conception of the work: YT and DL; acquisition, analysis, and interpretation of the data: YT, BZ, SZ, FD, RL, and SG; drafting the manuscript: YT; critically revise for important intellectual content: JH and DL; final approve of the manuscript: all authors.
Compliance with Ethical Standards
This is a single-center, retrospective study and was approved by the ethics committee of the Second Xiangya Hospital of Central South University, and all the patients signed informed consent.
- 5.Tan Y, Tang X, Guo T, Peng D, Tang Y, Duan T, Wang X, Lv L, Huo J, Liu D. Comparison between submucosal tunneling endoscopic resection and endoscopic full-thickness resection for gastric stromal tumors originating from the muscularis propria layer. Surg Endosc 2017;31:3376–3382.CrossRefGoogle Scholar
- 8.Du C, Chai N, Linghu E, Gao Y, Li Z, Li L, Zhai Y, Lu Z, Meng J, Tang P. Treatment of cardial submucosal tumors originating from the muscularis propria layer: submucosal tunneling endoscopic resection versus endoscopic submucosal excavation. Surg Endosc 2018; doi: https://doi.org/10.1007/s00464-018-6206-0.CrossRefGoogle Scholar
- 11.Xu MD, Cai MY, Zhou PH, Qin XY, Zhong YS, Chen WF, Hu JW, Zhang YQ, Ma LL, Qin WZ, Yao LQ. Submucosal tunneling endoscopic resection: a new technique for treating upper GI submucosal tumors originating from the muscularis propria layer (with videos). Gastrointest Endosc 2012;75:195–199.CrossRefGoogle Scholar
- 16.Demetri GD, von Mehren M, Antonescu CR, DeMatteo RP, Ganjoo KN, Maki RG, Pisters PW, Raut CP, Riedel RF, Schuetze S, Sundar HM, Trent JC, Wayne JD. NCCN Task Force report: update on the management of patients with gastrointestinal stromal tumors. J Natl Compr Cancer Netw 2010; Suppl 2:S1–41; quiz S42–44Google Scholar