Gastrointest Endosc. 2021 Nov 1:S0016-5107(21)01763-6. doi: 10.1016/j.gie.2021.10.026. Online ahead of print.
ABSTRACT
BACKGROUND AND AIMS: With the increasing incidence of small gastrointestinal stromal tumors (GISTs), endoscopic full-thickness resection (EFR) and cap-assisted EFR (EFR-C) have been suggested as 2 effective resection methods. We aimed to compare the outcomes of EFR and EFR-C for the treatment of small (≤ 1.5 cm) gastric GISTs.
METHODS: This retrospective study included 67 patients who underwent EFR and 46 patients who underwent EFR-C at Nanjing Drum Tower Hospital. Clinicopathological features, adverse events and outcomes were compared between the 2 groups. Univariate and multivariate linear and logistic regressions were used to analyze the effects of the procedure on the therapeutic outcomes of patients and adjusted for covariates in multivariate analysis.
RESULTS: The tumor size in the EFR group tended to be larger (P = 0.005). The resection time in the EFR-C group was shorter than that in the EFR group (38.3 ± 20.7 min vs 15.0 ± 11.8 min, P < 0.001), which retained statistical significance with adjustment for the covariates (adjusted mean difference: 22.2; 95% CI, 15.0-29.4, P < 0.001). The R0 resection rate of the EFR group was 94.0%, and for the EFR-C group, it was 97.8% (P = 0.355). The EFR-C group was superior to the EFR group in terms of perioperative therapeutic outcomes, adverse events and postoperative recovery. No recurrence occurred in the EFR and EFR-C groups.
CONCLUSION: EFR-C was found to be the preferable technique for small (≤1.5 cm) gastric GISTs with shorter operation times, lower adverse events, faster postoperative recovery, and shorter hospitalization times as compared with those with EFR.
PMID:34736933 | DOI:10.1016/j.gie.2021.10.026
