Comparing precutting endoscopic band ligation-assisted resection vs ESD for small gastric SMTs: a randomized controlled trial
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Updated: Oct 31, 2026
Evaluation of the Effectiveness of Longitudinal Incision for Endoscopic Submucosal Excavation of Gastric Subepithelial Lesions
Published on: April 28, 2026
Youping Zhou1, Mingfeng Liu2, Rui Yuan2
1Department of Gastroenterology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Gastroenteropancreatic Neuroendocrine Tumor Diagnosis and Treatment Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Background And Study Aims:
This study evaluated the clinical feasibility of precutting endoscopic band ligation-assisted resection (precutting EBLR) for the removal of small gastric submucosal tumors originating from the muscularis propria (gSMT-MP).
Methods:
This was a single-center, open-label, parallel-group randomized controlled trial (ChiCTR2200065473). All endoscopic procedures were performed by two experienced endoscopists (>300 ESD cases each). From January 2023 to December 2024, consecutive patients with gSMT-MP ≤ 16 mm were enrolled and randomly assigned to precutting EBLR or ESD. The primary outcome was operation time, additional clinical indicators were also collected and analyzed.
Results:
The median operation time was 17.5 min (range: 12-50) for the precutting EBLR group and 30 min (range: 12-80) for the ESD group. The median operation costs were $564.05 (range: $301.97-$1236.42) and $849.29 (range: $491.95-$2121.25), respectively. R0 and en-bloc resection were achieved in all patients. No delayed perforations or tumor recurrences occurred during follow-up.
Conclusion:
Precutting EBLR demonstrated advantages in operation time compared with ESD. It represents an efficient and safe endoscopic approach for treating gSMT-MPs ≤ 16 mm, and may be potentially applicable in non-academic or lower-volume centers, pending further validation.
