Endoscopic Full-Thickness Resection vs Submucosal Tunneling Endoscopic Resection for Gastric Submucosal Tumors

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery
• Endoscopic Oncology

Background:

• Submucosal tunneling allows access to deeper gastrointestinal layers or extraluminal spaces for tumor treatment.
• Submucosal tunneling endoscopic resection (STER) was developed based on this principle.
• This study compares STER with endoscopic full-thickness resection (EFTR) and evaluates STER-based Natural Orifice Transluminal Endoscopic Surgery (NOTES) for extra-gastrointestinal stromal tumors (EGISTs).

Purpose of the Study:

• To compare the clinical outcomes of exposed EFTR and nonexposed STER.
• To analyze the efficacy and safety of STER-based NOTES for EGISTs.

Main Methods:

• Retrospective analysis of 60 patients with gastric corpus tumors (July 2019-December 2023).
• Patients underwent either EFTR (n=31) or STER (n=29).
• Clinicopathologic features, treatment results, and follow-up outcomes were collected.

Main Results:

• EFTR had shorter procedure times (P=0.016) but longer hospital stays (P=0.004) than STER.
• Tumor size > 2 cm and endoloop-clips suture were linked to longer procedures.
• STER-based NOTES was successfully performed for EGISTs, with no local recurrence or distant metastasis during follow-up (6-60 months).

Conclusions:

• STER results in a shorter postoperative hospital stay than EFTR, despite longer procedure times.
• Tumor size and suture technique significantly impact STER procedure duration.
• STER-based NOTES is a promising and safe approach for resecting EGISTs.