Efficacy analysis of endoscopic submucosal excavation with mucosal layer preservation for gastric submucosal tumors
10.3760/cma.j.cn321463-20240520-00248
- VernacularTitle:保留黏膜层的内镜黏膜下挖除术治疗胃黏膜下肿瘤的有效性分析
- Author:
Jiaqi GE
1
;
Xiaomei SUN
1
Author Information
1. 黑龙江省医院消化病院消化内科，哈尔滨 150001
- Publication Type:Journal Article
- Keywords:
Stomach neoplasms;
Submucosal tumors;
Endoscopic submucosal excavation;
Therapeutic endoscopy;
Mucosal layer preservation
- From:
Chinese Journal of Digestive Endoscopy
2024;41(12):961-966
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy and safety of endoscopic submucosal excavation (ESE) with mucosal layer preservation and traditional ESE for patients with small (≤2 cm) gastric submucosal tumors (SMT) originating from muscularis propria.Methods:A retrospective study was performed on patients with gastric SMT (≤2 cm) originating from muscularis propria treated by ESE with mucosal layer preservation (mucosal layer preservation group, 30 cases) or traditional ESE (non-mucosal layer preservation group, 30 cases) in Digestive Disease Hospital, Heilongjiang Provincial Hospital from November 2021 to November 2022. Baseline characteristics (gender, age, tumor location and size) and endoscopy-related treatment outcomes including en bloc resection rate, operation time, intraoperative blood loss, intraoperative perforation rate and postoperative complications (bleeding, perforation, infection) rate, economic benefits, and postoperative hospitalization time were compared.Results:There was no significant difference in the baseline characteristics between the two groups ( P>0.05). As for en bloc resection rate [100.0% (30/30) VS 90.0% (27/30), P=0.237], intraoperative blood loss (23.34±14.68 mL VS 23.67±14.73 mL, t=0.085, P=0.932), intraoperative perforation rate [0.0% (0/30) VS 16.7% (5/30), P=0.052], and hospitalization time (5.17±1.46 days VS 5.93±1.59 days, t=1.939, P=0.057), there were no significant differences between the mucosal layer preservation group and the non-mucosal layer preservation group. No postoperative bleeding, perforation, fever or peritonitis occurred in either group. However, the operation time was shorter in the mucosal layer preservation group than that in the non-mucosal layer preservation group (47.07±14.03 min VS 59.47±16.75 min, t=3.107, P=0.003). The hospitalization expenses in the mucosal layer preservation group were significantly lower than those in the non-mucosal layer preservation group (22 109.68±3 960.65 yuan VS 28 378.64±3 842.31 yuan, t=6.222, P=0.001). Conclusion:Both ESE with mucosal layer preservation and traditional ESE are safe and reliable for patients with small (≤2 cm) gastric SMT originating from muscularis propria. Compared with traditional ESE, the mucosal layer preservation technique demonstrates a shorter operation time and reduces hospitalization expenses.
