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Updated: Apr 13, 2026
The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors
Published on: February 13, 2026
Endoscopic resection of gastric submucosal tumors: a single-center retrospective study
Yanting Guo1, Haisheng Qian1, Bozhi Wu1
1Department of Gastroenterology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, China; Department of Gastroenterology, The First School of Clinical Medicine of Nanjing Medical University, Nanjing, Jiangsu Province, China.
Background:
Gastric submucosal tumors (G-SMTs) refer to protuberant lesions originating from the muscularis mucosae, submucosa, or muscularis propria. Endoscopic resection (ER) has been adopted as a treatment option for G-SMTs. However, the indications for ER remain inconsistent across guidelines. This study aimed to provide further clinical evidence supporting the role of ER in the management of G-SMTs.
Methods:
This retrospective study included 531 of 949 patients with G-SMTs undergoing ER between June 2015 and June 2024. Baseline and lesion characteristics were collected. Among patients diagnosed as having gastrointestinal stromal tumors (GISTs), clinical features were compared in patients who achieved complete ER (ER0) with incomplete ER (ER1). Follow-up information was available for a subset of patients and was used to evaluate recurrence outcomes.
Results:
The mean age of patients was 56.4 ± 11.0 years, and the mean tumor size was 1.56 ± 0.97 cm. The mean procedural time for patients was 58 ± 32 min. Postoperative pathological evaluation revealed that GISTs and leiomyomas were the most common pathological types, accounting for 53.7% and 32.8% of cases. To evaluate the risk factors associated with piecemeal resection of GISTs, the patients were divided into 2 groups (ER0 and ER1). On univariate analysis, larger tumor size (P <.001), extraluminal growth pattern (P =.031), and high-risk grade (P =.02) were significantly associated with incomplete resection, whereas multivariable analysis identified tumor size as the only independent risk factor (odds ratio, 3.389; 95% CI, 1.799-6.385; P <.001). During follow-up, only 2 patients experienced recurrence, and overall recurrence-free survival remained high.
Conclusion:
ER is a safe and effective therapeutic method for specific G-SMTs. For GISTs, tumor size is the main factor associated with incomplete resection.
