Comparison between endoscopic and laparoscopic removal of gastric submucosal tumor

Abstract

Results: The ER group had a significantly higher percentage of intraluminal growing type of tumor (100% vs 41%) and smaller tumor size (23 vs 33 mm) than the LR group. The ER group had a significantly shorter operative time (93 vs 145 min) and less blood loss (13 vs 30 mL) than the LR group. In the ER group, three patients who had tumors located on the anterior wall of the stomach required laparoscopic closure after EFTR because of difficulty in endoscopic closure of the gastric-wall defect. Postoperative complication rates and duration of postoperative hospital stays did not differ between the two groups.Conclusions: ER may be technically feasible, safe, less invasive, and oncologically appropriate options for selected patients with the intraluminal growing type of G-SMT smaller than 30 mm. EFTR may be more reasonable alternatives to LR in selected patients with a small G-SMT located on the lesser curvature side.

Efficacy and safety of gastric exposed endoscopic full-thickness resection without laparoscopic assistance: a systematic review

“…Of these potential papers, 35 were excluded (▶ Table 1). Finally, 15 original articles were included in final analysis [10][11][12][22][23][24][25][26][27][28][29][30][31][32][33]. A flow diagram summarizing the procedure of study selection is presented in ▶ Fig.…”

“…The per-lesion rate of surgical conversion was 0.8 %. Conversion to surgery was reported in three studies [12,30,32], who described one, three, and two cases of surgical conversions, respectively. Among the six cases of surgical conversion reported across the included studies, laparoscopic surgery was performed in all cases.…”

“…Among the six cases of surgical conversion reported across the included studies, laparoscopic surgery was performed in all cases. Conversion to laparoscopy was performed because of difficulty in endoscopic closure of the wall defect in three cases [30], whereas intraprocedural tumor fall into the peritoneal cavity [12], large size and hardness of the tumor [32] and difficulty of tumor dissection [32] were the cause of laparascopic conversion in the remnant three cases, respectively.…”

Endoscopic selective muscular dissection for gastric submucosal tumor

“…Gastric submucosal tumors (G‐SMT), such as gastrointestinal stromal tumors (GIST), often arise from the muscularis propria, which consists of at least two layers (inner circle and outer longitudinal muscle). Laparoscopic and endoscopic cooperative surgery or endoscopic resection has been carried out for G‐SMT . However, these procedures require closure of the gastric wall.…”

Surgical Endoscopy: Future Directions

“…A retrospective study comparing endoscopic and laparoscopic resection of gastric submucosal tumors found endoscopic resection to require shorter operative times, less blood loss, and no difference in postoperative complications. 22 While these procedures are currently less invasive, safe, and feasible, a lag in incorporation into national guidelines will likely exist until long-term data are available and results are replicable outside of centers of excellence.…”