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A multicenter retrospective study of endoscopic submucosal tunnel dissection for large lesser gastric curvature superficial neoplasms

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Abstract

Background and aim

Endoscopic submucosal tunnel dissection (ESTD) has been used for dissection of esophageal and gastric lesions. However, outcomes of ESTD for large lesions in the lesser gastric curvature had not been acknowledged because previous reports had the limitations of being single-center studies. We aimed to clarify the outcomes of ESTD for large lesser gastric curvature superficial neoplasms and provide our experience to accelerate its application.

Methods

Between July 2014 and July 2016, 87 patients with early cancer in the lesser gastric curvature treated at six Chinese institutions were enrolled. Our primary outcome was dissection speed. Moreover, both efficacy and safety clinical data were collected and analyzed retrospectively.

Results

All of the 87 patients were found to successfully undergo ESTD or ESD. Of these, 32 underwent ESTD and 55 underwent endoscopic submucosal dissection (ESD). The ESTD group had a higher dissection speed (18.0 mm2/min vs. 7.8 mm2/min, p < 0.01) and was associated with higher en bloc resection rate (100% vs. 87.3%, p = 0.035) and curative resection rate (100% vs. 85.5%, p = 0.024) compared with the ESD group. No perforation or muscular injury occurred in the ESTD group and its intraprocedural bleeding rate was lower (59.4% vs. 100%, p < 0.01) than that of the ESD group.

Conclusions

In this multicenter retrospective study, outcomes of ESTD were excellent with a higher dissection speed and radical curative rate compared with ESD.

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Authors and Affiliations

  1. Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China

    Xing Zhang, Dongtao Shi, Zhuwen Yu, Rui Li & Weichang Chen

  2. Department of Gastroenterology, Ningxia Hui Autonomous Region People’s Hospital, Yinchuan, 750021, China

    Feihu Bai

  3. Department of Gastroenterology, Yancheng First Peoples’ Hospital, Yancheng, 224005, China

    Xudong Wu

  4. Department of Gastroenterology, Changshu Second People’s Hospital, Changshu, 215500, China

    Cuie Cheng

  5. Department of Gastroenterology, Zhongda Hospital Affiliated to Southeast University, Nanjing, 210009, China

    Ruihua Shi

  6. Department of Gastroenterology, Jiangsu Province People’s Hospital, Jiangyin, 214400, China

    Pengfei Liu

Authors
  1. Xing Zhang
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  2. Dongtao Shi
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  3. Zhuwen Yu
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  4. Rui Li
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  5. Weichang Chen
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  6. Feihu Bai
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  7. Xudong Wu
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  8. Cuie Cheng
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  9. Ruihua Shi
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  10. Pengfei Liu
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Corresponding author

Correspondence to Rui Li.

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Disclosures

Drs. Xing Zhang, Dongtao Shi, Zhuwen Yu, Rui Li, Weichang Chen, Feihu Bai, Xudong Wu, Cuie Cheng, Ruihua Shi, and Pengfei Liu have no conflicts of interest or financial ties to disclose.

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Zhang, X., Shi, D., Yu, Z. et al. A multicenter retrospective study of endoscopic submucosal tunnel dissection for large lesser gastric curvature superficial neoplasms. Surg Endosc 33, 1910–1919 (2019). https://doi.org/10.1007/s00464-018-6471-y

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  • DOI: https://doi.org/10.1007/s00464-018-6471-y

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