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Efficacy and Safety of Endoscopic Resection for Gastric Gastrointestinal Stromal Tumors Originating from the Muscularis Propria.
- Source :
-
Digestive diseases and sciences [Dig Dis Sci] 2024 Jun; Vol. 69 (6), pp. 2184-2192. Date of Electronic Publication: 2024 Apr 23. - Publication Year :
- 2024
-
Abstract
- Background: The role of endoscopic resection (ER) in gastric gastrointestinal stromal tumors (GISTs) has not been fully elucidated.<br />Aims: The purpose of this work was to evaluate the clinical effectiveness and safety of ER in patients with GISTs originating from the muscularis propria (MP).<br />Methods: A total of 233 consecutive patients with gastric GISTs originating from the MP layer, who underwent ER between February 2012 and May 2023, were included in this study. Clinical characteristics, tumor features, and outcomes were recorded and compared between patients who underwent en bloc resection and piecemeal resection.<br />Results: Among the 233 patients, the median size of GISTs was 12 mm (range 5-60 mm). Risk assessment categorized 190 patients as very low risk, 26 as low risk, 10 as moderate risk, and 7 as high risk. The procedures performed included endoscopic submucosal excavation (127 cases), endoscopic full-thickness resection (103 cases), and submucosal tunneling endoscopic resection (3 cases). The complete and R0 resection rate was 93.1%. Complications occurred in 4.7% of cases (perioperative perforations 1.7%, perioperative bleeding 1.3%, both 0.9%), resulting in conversion to surgery in 1.3% of cases. Risk factors associated with piecemeal resection were tumor size [odds ratio (OR) 0.402, 95% confidence interval (CI) 0.207-0.783; Pā=ā0.007] and shape (OR 0.045, 95% CI 0.009-0.235; Pā<ā0.001).<br />Conclusions: ER is proven to be an effective and reasonably safe approach for gastric GISTs originating from the MP. Notably, larger tumor size and irregular shape are identified as risk factors for piecemeal resection during ER procedures.<br /> (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
- Subjects :
- Humans
Male
Female
Middle Aged
Aged
Adult
Aged, 80 and over
Endoscopic Mucosal Resection methods
Endoscopic Mucosal Resection adverse effects
Gastric Mucosa surgery
Gastric Mucosa pathology
Treatment Outcome
Retrospective Studies
Gastroscopy methods
Gastroscopy adverse effects
Risk Factors
Postoperative Complications epidemiology
Postoperative Complications etiology
Gastrointestinal Stromal Tumors surgery
Gastrointestinal Stromal Tumors pathology
Stomach Neoplasms surgery
Stomach Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1573-2568
- Volume :
- 69
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Digestive diseases and sciences
- Publication Type :
- Academic Journal
- Accession number :
- 38653945
- Full Text :
- https://doi.org/10.1007/s10620-024-08359-z