RSS-Feed abonnieren
DOI: 10.1055/a-2013-1902
No-touch endoscopic full-thickness resection technique for gastric gastrointestinal stromal tumors
Gefördert durch: The Top-level Clinical Discipline Project of Shanghai Pudong PWYgf2021–2Gefördert durch: Shanghai Committee of Science and Technology 19411951505
Abstract
Background There remain concerns regarding the technical feasibility of endoscopic resection for large gastrointestinal stromal tumors (GISTs), mainly relating to the risk of tumor rupture and the adequacy of the resection margins. This study aimed to evaluate the feasibility and therapeutic outcomes of the newly developed no-touch endoscopic full-thickness resection (NT-EFTR) technique for GISTs.
Methods In this retrospective study, 92 patients with gastric GISTs undergoing NT-EFTR were included. Clinicopathological, endoscopic, and follow-up data were collected and analyzed.
Results The median tumor size was 2.5 cm and en bloc resection was achieved in all patients with negative surgical margins. The median time of the NT-EFTR procedure was 59.5 minutes. Large tumors (> 3.0 cm), extraluminal tumor growth pattern, and large gastric defects were significant contributors to long operative times. Patients were discharged within 4 days postoperatively. During follow-up, all patients were free from local recurrence and distant metastasis.
Conclusions NT-EFTR was a feasible method for the resection of gastric GISTs and can be expected to achieve complete radical resection. Large tumors with extraluminal growth and large gastric defects impact procedural difficulty.
‡ These authors contributed equally to this paper.
Publikationsverlauf
Eingereicht: 04. April 2022
Angenommen nach Revision: 22. November 2022
Artikel online veröffentlicht:
09. Februar 2023
© 2023. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Joensuu H, Hohenberger P, Corless CL. Gastrointestinal stromal tumour. Lancet 2013; 382: 973e983
- 2 Casali PG, Abecassis N, Aro HT. et al. Gastrointestinal stromal tumours: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2018; 29: iv68-iv78
- 3 von Mehren M, Randall RL, Benjamin RS. et al. Soft tissue sarcoma, version 2.2018, NCCN clinical practice guidelines in Oncology. J Natl Compr Canc Netw 2018; 16: 536-563
- 4 Koh YX, Chok AY, Zheng HL. et al. A systematic review and meta-analysis comparing laparoscopic versus open gastric resections for gastrointestinal stromal tumors of the stomach. Ann Surg Oncol 2013; 20: 3549-3560
- 5 Chen T, Zhang C, Yao LQ. et al. Management of the complications of submucosal tunneling endoscopic resection for upper gastrointestinal submucosal tumors. Endoscopy 2016; 48: 149-155
- 6 Chen T, Zhou PH, Chu Y. et al. Long-term outcomes of submucosal tunneling endoscopic resection for upper gastrointestinal submucosal tumors. Ann Surg 2017; 265: 363-369
- 7 Chen T, Lin ZW, Zhang YQ. et al. Submucosal tunneling endoscopic resection vs thoracoscopic enucleation for large submucosal tumors in the esophagus and the esophagogastric junction. J Am Coll Surg 2017; 225: 806-816
- 8 Chen T, Wang GX, Lian JJ. et al. Submucosal tunneling endoscopic resection for submucosal tumors in the proximal esophagus. J Am Coll Surg 2022; 234: 1127-1135
- 9 Xu M, Wang XY, Zhou PH. et al. Endoscopic full-thickness resection of colonic submucosal tumors originating from the muscularis propria: an evolving therapeutic strategy. Endoscopy 2013; 45: 770-773
- 10 Joensuu H. Risk stratification of patients diagnosed with gastrointestinal stromal tumor. Hum Pathol 2008; 39: 1411-1419