Clinical Control Study of Endoscopic Full-thickness Resection and Laparoscopic Surgery in the Treatment of Gastric Tumors Arising from the Muscularis Propria

Cheng-Rong Wu, Liu-Ye Huang, Juan Guo, Bo Zhang, Jun Cui, Cheng-Ming Sun, Li-Xin Jiang, Zhi-Hua Wang, Ai-Hong Ju, Cheng-Rong Wu, Liu-Ye Huang, Juan Guo, Bo Zhang, Jun Cui, Cheng-Ming Sun, Li-Xin Jiang, Zhi-Hua Wang, Ai-Hong Ju

Abstract

Background: Gastric stromal tumors arising from the muscularis propria are located in deeper layers. Endoscopic resection may be contraindicated due to the possibility of perforation. These tumors are therefore usually removed by surgical or laparoscopic procedures. This study evaluated the curative effects, safety and feasibility of endoscopic full-thickness resection (EFR) of gastric stromal tumors originating from the muscularis propria.

Methods: This study enrolled 92 patients with gastric stromal tumors >2.5 cm originating from the muscularis propria. Fifty patients underwent EFR, and 42 underwent laparoscopic intragastric surgery. Operation time, complete resection rate, length of hospital stay, incidence of complications, and recurrence rates were compared in these two groups.

Results: EFR resulted in complete resection of all 50 gastric stromal tumors, with a mean procedure time of 85 ± 20 min, a mean hospitalization time of 7.0 ± 1.5 days and no complications. Laparoscopic intragastric surgery also resulted in a 100% complete resection rate, with a mean operation time of 88 ± 12 min and a mean hospitalization period of 7.5 ± 1.6 days. The two groups did not differ significantly in operation time, complete resection rates, hospital stay or incidence of complications (P > 0.05). No patient in either group experienced tumor recurrence.

Conclusions: EFR technique is effective and safe for the resection of gastric stromal tumors arising from the muscularis propria.

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Endoscopic full-thickness resection treatment of gastric stromal tumors arising from the muscularis propria. (a) A protruding submucosal lesion in the gastric fundus; (b) Endoscopic ultrasound showing that the lesion arose from the muscularis propria; (c) Submucosal injection of saline containing adrenaline and indigo carmine; (d) Application of the IT knife to isolate the stromal tumor along its periphery; (e) An artificial perforation observed after stromal tumor resection; (f) Sealing of a perforation with multiple titanium clips; (g) Resected tumor with the mucosa removed (5 cm in diameter); (h) View 9 days after the operation, showing that the perforation healed well.
Figure 2
Figure 2
Laparoscopic resection of gastric stromal tumors. (a) Layout of instruments for laparoscopic surgery; (b) Laparoscopic resection of a gastric stromal tumor; (c) Removed tumor (4 cm in diameter).

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Source: PubMed

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