Safety and Efficacy of Exposed Endoscopic Full-thickness Resection for Colorectal Submucosal Tumors Originating from Muscularis Propria

Abstract

Objectives Endoscopic resection of the submucosal tumors (SMTs) is a promising minimally invasive alternative surgery for the treatment of SMTs. The aim of this study was to evaluate the safety and efficacy of exposed EFTR in the treatment of colorectal SMTs through retrospective data analysis. Methods The patients who underwent exposed endoscopic full-thickness resection (EFTR) for colorectal SMTs in Zhongshan Hospital of Fudan University and Zhongshan-Xuhui Hospital between March 2012 and December 2022 were enrolled. The information of patients, such as basic information, medical history, preoperative and postoperative conditions, surgical conditions, postoperative complications, etc. were collected for analysis. Results The study enrolled 26 patients. Most of the patients were asymptomatic (76.92%) and found the colorectal SMT through physical examination. The size of the tumor was13.5(8.5,20.0) mm. And, the tumor located mostly in the rectum. During the resection, the technical success rate was 100%. The median procedural time was 46.5(29.25,63.25) min. Of the 26 cases of colorectal SMTs, 13 (50%) were determined to be GIST. As for the adverse events, 3 of the 26 patients were suffered from post-polypectomy syndrome (11.54%), one patient was suffered from postoperative bleeding (3.85%), of whom performed emergency endoscopic hemostasis; One patient (3.85) suffered from postoperative perforation and transferred to perform exploratory laparotomy to repair the defect. All patients improved after treatment, and no patient died because of the adverse events. During the follow-up time 43.5(22.5,48) months, no metastasis or recurrence was observed. Conclusions Exposed EFTR for colorectal SMTs originating from muscularis propria is effective with an acceptable incidence rate of adverse events and good postoperative recovery.