Endoscopic full-thickness resection for gastric submucosal tumors: Japanese multicenter prospective study

被引：20

作者：

Shichijo, Satoki ^{[1
]}

Uedo, Noriya ^{[1
,9
]}

Sawada, Atsushi ^{[2
]}

Hirasawa, Kingo ^{[2
]}

Takeuchi, Hirohisa ^{[3
]}

Abe, Nobutsugu ^{[3
]}

Miyaoka, Masaki ^{[5
]}

Yao, Kenshi ^{[5
]}

Dobashi, Akira ^{[4
]}

Sumiyama, Kazuki ^{[4
]}

Ishida, Tsukasa ^{[6
]}

Morita, Yoshinori ^{[7
]}

Ono, Hiroyuki ^{[8
]}

机构：

[1] Osaka Int Canc Inst, Dept Gastrointestinal Oncol, Osaka, Japan

[2] Yokohama City Univ Med Ctr, Endoscopy Div, Kanagawa, Japan

[3] Kyorin Univ, Dept Gastroenterol & Gen Surg, Sch Med, Tokyo, Japan

[4] Jikei Univ, Dept Endoscopy, Sch Med, Tokyo, Japan

[5] Fukuoka Univ, Dept Endoscopy, Chikushi Hosp, Fukuoka, Japan

[6] Akashi Med Ctr, Dept Gastroenterol, Hyogo, Japan

[7] Kobe Univ, Int Clin Canc Res Ctr, Dept Gastroenterol, Kobe, Japan

[8] Shizuoka Canc Ctr, Endoscopy Div, Shizuoka, Japan

[9] Osaka Int Canc Inst, Dept Gastrointestinal Oncol, 3-1-69 Otemae,Chuo ku, Osaka 5418567, Japan

来源：

DIGESTIVE ENDOSCOPY | 2024年 / 36卷 / 07期

关键词：

endoscopy; full-thickness resection; gastrointestinal stromal tumor; phase II study; submucosal tumor; GASTROINTESTINAL STROMAL TUMORS; LONG-TERM OUTCOMES; COOPERATIVE SURGERY; DEFECT CLOSURE; FEASIBILITY; RUPTURE; DEFINITION; VALIDATION; DISSECTION; DIAGNOSIS;

D O I：

10.1111/den.14717

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

ObjectivesEarly gastric cancer endoscopic resection (ER) is prominent in Japan. However, evidence regarding ER of gastric submucosal tumors (SMT) is limited. This prospective multicenter phase II study investigated the efficacy and safety of endoscopic full-thickness resection (EFTR) for gastric SMT.MethodsEndoscopic full-thickness resection indication for gastric SMT was 11-30 mm, histologically proven or clinically suspicious (irregular margin, increasing size, or internal heterogeneity) gastrointestinal stromal tumors (GIST), with no ulceration and intraluminal growth type. The primary end-point was the complete ER (ER0) rate, with a sample size of 42.ResultsWe enrolled 46 patients with 46 lesions between September 2020 and May 2023 at seven Japanese institutions. The mean +/- SD (range) endoscopic tumor size was 18.8 +/- 4.5 (11-28) mm. The tumor resection and defect closure times were 54 +/- 26 (22-125) min and 33 +/- 28 (12-186) min, respectively. A 100% ER0 was achieved in all 46 patients. The EFTR procedure was accomplished in all patients without surgical intervention. One patient had delayed perforation and was managed endoscopically. GIST accounted for 76% (n = 35) of the cases. R0, R1, and RX rates were 33 (77%), 3 (6.5%), and 7 (15%), respectively.ConclusionEndoscopic full-thickness resection for gastric SMT of 11-30 mm is efficacious. It warrants further validation in a large-scale cohort study to determine the long-term outcome of this treatment for patients with gastric GIST.

引用

页码：811 / 821

页数：11

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