Surgical endoscopy · 2026
Endoscopic full-thickness resection of upper gastrointestinal stromal tumors: a retrospective study from a large tertiary hospital in China.
СтатьяНазвание и аннотация: Перевод в очереди
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Lin Bitao, Yang Lu, Lu Jingyi, Li Ruijia, Li Danyi, Chen Zhitao, Liu Side, Han Zelong, Chai Yixia
Аннотация
BACKGROUND AND AIMS: With the rapid development of endoscopic technology, endoscopic resection (ER) of gastrointestinal stromal tumors (GISTs) has been an alternative therapeutic strategy. However, endoscopic full-thickness resection (EFTR) for GISTs still presents certain technical difficulties and challenges. The study aimed to evaluate the efficacy, safety, and long-term outcomes of EFTR for GISTs in the upper gastrointestinal (UGI) tract.
METHODS: 238 patients with UGI GISTs who underwent EFTR from October 2016 to September 2024 were retrospectively enrolled into this study. Clinicopathologic characteristics, procedure-related outcomes, postoperative adverse events, and follow-up results were collected and analyzed.
RESULTS: The endoscopic complete resection (ER0) and histological complete resection (R0) rates were 99.58% and 95.80%, respectively. The mean tumor size measured under endoscopic evaluation was 17.22 ± 8.36 mm (range 4-50 mm). The average procedure time was 52.96 ± 38.21 min, comprising a resection time of 33.46 ± 26.50 min and a wound closure time of 19.50 ± 18.59 min. Ten patients (4.20%) experienced major adverse events, including delayed bleeding in one case (0.42%), delayed perforation in one case (0.42%), peritonitis in four cases (1.68%), hydrothorax in three cases (1.26%), and aspiration pneumonia in four cases (1.68%). Besides, thirty-six procedures (15.13%) experienced technical difficulty. The multivariate analysis revealed that procedures performed by non-experts, tumors presenting predominantly extraluminal growth, and tumors with diameters of 20-30 mm and ≥ 30 mm were independent risk factors for technical difficulty. No patients encountered recurrence and metastasis during the mean follow-up times of 44.15 ± 24.83 months.
CONCLUSION: EFTR is a safe and effective technique for treating UGI GISTs. Further prospective studies are needed to determine the role of EFTR in treating GISTs.
METHODS: 238 patients with UGI GISTs who underwent EFTR from October 2016 to September 2024 were retrospectively enrolled into this study. Clinicopathologic characteristics, procedure-related outcomes, postoperative adverse events, and follow-up results were collected and analyzed.
RESULTS: The endoscopic complete resection (ER0) and histological complete resection (R0) rates were 99.58% and 95.80%, respectively. The mean tumor size measured under endoscopic evaluation was 17.22 ± 8.36 mm (range 4-50 mm). The average procedure time was 52.96 ± 38.21 min, comprising a resection time of 33.46 ± 26.50 min and a wound closure time of 19.50 ± 18.59 min. Ten patients (4.20%) experienced major adverse events, including delayed bleeding in one case (0.42%), delayed perforation in one case (0.42%), peritonitis in four cases (1.68%), hydrothorax in three cases (1.26%), and aspiration pneumonia in four cases (1.68%). Besides, thirty-six procedures (15.13%) experienced technical difficulty. The multivariate analysis revealed that procedures performed by non-experts, tumors presenting predominantly extraluminal growth, and tumors with diameters of 20-30 mm and ≥ 30 mm were independent risk factors for technical difficulty. No patients encountered recurrence and metastasis during the mean follow-up times of 44.15 ± 24.83 months.
CONCLUSION: EFTR is a safe and effective technique for treating UGI GISTs. Further prospective studies are needed to determine the role of EFTR in treating GISTs.