Endoscopy 2019; 51(04): S104
DOI: 10.1055/s-0039-1681477
ESGE Days 2019 oral presentations
Saturday, April 6, 2019 11:00 – 13:00: ESD stomach 2 Club A
Georg Thieme Verlag KG Stuttgart · New York

COMPARISON OF NON-EXPOSURE SIMPLE SUTURING ENDOSCOPIC FULL-THICKNESS RESECTION (NESS-EFTR) AND LECS FOR GASTRIC SUBEPITHELIAL TUMORS

CG Kim
1   National Cancer Center, Center for Gastric Cancer, Goyang, Korea, Republic of
,
DI Choi
1   National Cancer Center, Center for Gastric Cancer, Goyang, Korea, Republic of
,
HM Yoon
1   National Cancer Center, Center for Gastric Cancer, Goyang, Korea, Republic of
,
BW Eom
1   National Cancer Center, Center for Gastric Cancer, Goyang, Korea, Republic of
,
KW Ryu
1   National Cancer Center, Center for Gastric Cancer, Goyang, Korea, Republic of
,
YW Kim
1   National Cancer Center, Center for Gastric Cancer, Goyang, Korea, Republic of
,
YI Kim
1   National Cancer Center, Center for Gastric Cancer, Goyang, Korea, Republic of
,
JY Lee
1   National Cancer Center, Center for Gastric Cancer, Goyang, Korea, Republic of
,
IJ Choi
1   National Cancer Center, Center for Gastric Cancer, Goyang, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

Laparoscopy and endoscopic cooperative surgery (LECS) has the limitation of tumor exposure to peritoneal cavity. Recently, endoscopic full-thickness resection (EFTR) method which does not expose the tumor to peritoneal cavity (NESS-EFTR) was developed. We evaluated the NESS-EFTR technique with LECS.

Methods:

We compared the outcomes of two prospective trials (with LECS or NESS-EFTR) for the resection of gastric subepithelial tumor. NESS-EFTR procedure including steps of laparoscopic seromuscular suturing which results in inversion of the stomach wall, EFTR of the inverted stomach wall, and finally, endoscopic mucosal suturing with endoloops and clips. Fifteen patients were prospectively enrolled in both studies, respectively. Primary outcome was the rates of complete resection. Follow-up endoscopy was performed 3 months after EFTR.

Results:

A total of 11 (NESS-EFTR) and 14 patients (LECS) could be analyzed. The tumors were located at cardia in 64% (7/11) and 35.7% (5/14) of each group (p = 0.24). The tumor sizes (median) were not different between two groups (2.2 in NESS-EFTR and 2.6 cm in LECS, p = 0.12). The rate of complete resection was 100% in both groups. Total operation time (mean ± SD) is longer in NESS-EFTR group than that of LECS (198 ± 62 vs. 119 ± 36 minutes, p = 0.001). There is no complication except a transient fever in NESS-EFTR group. Peritoneal recurrence of GIST was occurred in a patient of LECS group after 17 months after operation.

Conclusions:

NESS-EFTR and LECS were successful in all patients. NESS-EFTR has the longer operation time, but has an advantage of non-exposure of tumor to peritoneal cavity. Further large-scale long-term follow-up study is needed.