Year 2018 / Volume 110 / Number 3
Original
A comparison of submucosal tunneling endoscopic resection and endoscopic full-thickness resection for gastric fundus submucosal tumors

160-165

DOI: 10.17235/reed.2017.4699/2016

Tian-Ying Duan, Yu-Yong Tan, Xue-Hong Wang, Liang Lv, De-Liang Liu,

Abstract
Aim: Both submucosal tunneling endoscopic resection (STER) and endoscopic full-thickness resection (EFTR) are effective methods for gastric fundus submucosal tumors (SMTs). However, there is little data that compares the two methods. The aim of this study was to compare the safety and efficacy of STER and EFTR for the treatment of SMTs in the gastric fundus. Methods: Clinical data was retrospectively collected from patients with gastric fundus SMTs who underwent STER or EFTR at our hospital from April 2011 to May 2016. Epidemiological data (gender, age), tumor size, procedure-related parameters, complications, postoperative hospital stay, cost and follow-up data were compared. Results: A total of 43 patients were enrolled: 15 underwent STER and the remaining 28 cases underwent EFTR. There were no significant differences between the two groups with regard to gender, age, tumor size, en bloc resection rate, operation time, pathohistological results and cost (p > 0.05). However, patients who underwent EFTR had a longer suture time, required a larger number of clips for closure and a prolonged postoperative hospital stay (p < 0.05). No recurrence was noted in either the STER or the EFTR group during a mean follow-up of 12.1 and 22.8 months, respectively. Conclusions: The treatment efficacy of STER and EFTR for the treatment of gastric fundus SMTs was comparable. However, STER has some advantages over EFTR in terms of suture time, the number of clips required for closure and postoperative hospital stay.
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References
[1] Nishida T, Kawai N, Yamaguchi S, et al. Submucosal tumors: comprehensive guide for the diagnosis and therapy of gastrointestinal submucosal tumors. Dig Endosc. 2013;25:479-489.
[2] Koga T, Hirayama Y, Yoshiya S, et al. Necessity for resection of gastric gastrointestinal stromal tumors ≤20 mm. Anticancer Res. 2015;35(4):2341–2344.
[3] Kim SY, Kim KO. Management of gastric subepithelial tumors: The role of endoscopy. World J Gastrointest Endosc. 2016;8:418-424.
[4] Zhang Y, Ye LP, Mao XL. Endoscopic treatments for small gastric subepithelial tumors originating from muscularis propria layer. World J Gastroenterol. 2015;21:9503-9511.
[5] Zhou PH, Yao LQ, Qin XY, et al. Endoscopic full-thickness resection without laparoscopic assistance for gastric submucosal tumors originated from the muscularis propria. Surg Endosc. 2011;25:2926-2931.
[6] Huang LY, Cui J, Lin SJ, et al. Endoscopic full-thickness resection for gastric submucosal tumors arising from the muscularis propria layer. World J Gastroenterol. 2014;20:13981-13986.
[7] Guo J, Liu Z, Sun S, et al. Endoscopic full-thickness resection with defect closure using an over-the-scope clip for gastric subepithelial tumors originating from the muscularis propria. Surg Endosc. 2015;29:3356-3362.
[8] Chiu PW, Phee SJ, Wang Z, et al. Feasibility of full-thickness gastric resection using master and slave transluminal endoscopic robot and closure by Overstitch: a preclinical study. Surg Endosc. 2014;28:319-324.
[9] Shi Q, Chen T, Zhong YS, et al. Complete closure of large gastric defects after endoscopic full-thickness resection using endoloop and metallic clip interrupted suture. Endoscopy. 2013;45:329-334.
10. Schlag C, Wilhelm D, von Delius S, et al. EndoResect study: endoscopic full-thickness resection of gastric subepithelial tumors. Endoscopy. 2013; 45(1): 4-11. DOI: 10.1055/s-0032-1325760.
[11] Xu MD, Cai MY, Zhou PH, et al. 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.
[12] Lu J, Zheng M, Jiao T, et al. Transcardiac tunneling technique for endoscopic submucosal dissection of gastric fundus tumors arising from the muscularis propria. Endoscopy. 2014;46:888-892.
[13] Li QL, Chen WF, Zhang C, et al. Clinical impact of submucosal tunneling endoscopic resection for the treatment of gastric submucosal tumors originating from the muscularis propria layer (with video). Surg Endosc. 2015;29:3640-3646.
[14] Wang H, Tan Y, Zhou Y, et al. Submucosal tunneling endoscopic resection for upper gastrointestinal submucosal tumors originating from the muscularis propria layer. Eur J Gastroenterol Hepatol. 2015;27:776-780.
15. Demetri GD, von Mehren M, Antonescu CR, et al. NCCN Task Force report: update on the management of patients with gastrointestinal stromal tumors. J Natl Compr Canc Netw. 2010;8 (Suppl 2:S1-41); quiz S42-44.
[16] Schmidt A, Meier B, Caca K. Endoscopic full-thickness resection: Current status. World J Gastroenterol. 2015;21:9273-9285.
[17] Maple JT, Abu DBK, Chauhan SS, et al. Endoscopic submucosal dissection. Gastrointest Endosc. 2015;81:1311-1325.
[18] Zhang Y, Ye LP, Zhou XB, et al. Safety and efficacy of endoscopic excavation for gastric subepithelial tumors originating from the muscularis propria layer: results from a large study in China. J Clin Gastroenterol. 2013;47:689-694.
[19] Suzuki H, Ikeda K. Endoscopic mucosal resection and full thickness resection with complete defect closure for early gastrointestinal malignancies. Endoscopy. 2001;33:437-439.
[20] Ikeda K, Fritscher-Ravens A, Mosse CA, et al. Endoscopic full-thickness resection with sutured closure in a porcine model. Gastrointest Endosc. 2005;62:122-129.
[21] von RD, Rosch T, Kratt T, et al. Endoscopic full-thickness resection of submucosal gastric tumors. Dig Dis Sci. 2012;57:1298-1303.
[22] Conway NE, Swanstrom LL. Endoluminal flexible endoscopic suturing for minimally invasive therapies. Gastrointest Endosc. 2015;81:262-269.e19.
[23] Zhang Y, Wang X, Xiong G, et al. Complete defect closure of gastric submucosal tumors with purse-string sutures. Surg Endosc. 2014;28:1844-1851.
[24] Hashiba K, Carvalho AM, Diniz G Jr, et al. Experimental endoscopic repair of gastric perforations with an omental patch and clips. Gastrointest Endosc. 2001;54:500-504.
[25] Minami S, Gotoda T, Ono H, et al. Complete endoscopic closure of gastric perforation induced by endoscopic resection of early gastric cancer using endoclips can prevent surgery (with video). Gastrointest Endosc. 2006;63:596-601.
[26] Inoue H, Ikeda H, Hosoya T, et al. Submucosal endoscopic tumor resection for subepithelial tumors in the esophagus and cardia. Endoscopy. 2012;44:225-230.
[27] Tan Y, Lv L, Duan T, et al. Comparison between submucosal tunneling endoscopic resection and video-assisted thoracoscopic surgery for large esophageal leiomyoma originating from the muscularis propria layer. Surg Endosc. 2016;30:3121-3127.
[28] Liu BR, Song JT. Submucosal Tunneling Endoscopic Resection (STER) and Other Novel Applications of Submucosal Tunneling in Humans. Gastrointest Endosc Clin N Am. 2016;26:271-282.
[29] Wang L, Ren W, Zhang Z, et al. Retrospective study of endoscopic submucosal tunnel dissection (ESTD) for surgical resection of esophageal leiomyoma. Surg Endosc. 2013;27:4259-4266.
[30] Lu J, Jiao T, Zheng M, et al. Endoscopic resection of submucosal tumors in muscularis propria: the choice between direct excavation and tunnelingresection. Surg Endosc. 2014;28:3401-3407.
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Duan T, Tan Y, Wang X, Lv L, Liu D. A comparison of submucosal tunneling endoscopic resection and endoscopic full-thickness resection for gastric fundus submucosal tumors. 4699/2016


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Publication history

Received: 30/10/2016

Accepted: 07/11/2017

Online First: 29/12/2017

Published: 28/02/2018

Article revision time: 370 days

Article Online First time: 425 days

Article editing time: 486 days


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