Jiao Ruonan, Zhao Si, Jiang Wei, Wei Xin, Huang Guangming
Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
Cancer Manag Res. 2020 May 29;12:4055-4061. doi: 10.2147/CMAR.S252459. eCollection 2020.
Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal neoplasms. Endoscopic submucosal dissection (ESD) has been used to remove submucosal tumours for many years. However, whether ESD can be recommended for the treatment of GISTs is still controversial. Therefore, we evaluated the efficacy and safety of ESD for treating GISTs.
We retrospectively analysed 75 GIST patients who underwent ESD in our hospital from January 2016 to December 2018, and the demographic data, clinical presentation of tumours, operative parameters, postoperative complications and length of hospital stay were analysed.
Seventy-five patients successfully underwent en bloc resection, and 74 (98.7%) patients underwent complete resection of the lesions, with an average tumour size of 1.7 cm (range 0.3-6.0 cm). The median operation time was 84.8 min (range 20-180 min). Forty-two (56.0%) patients underwent endoscopic purse-string suture with no conversions to an open operation. The median postoperative length of hospitalization was 6.6 days (range 3-14 days). Out of a total of 75 GIST patients, 48 (64.0%) were considered very low risk, 19 (25.3%) were low risk, 5 (6.7%) were mild risk, and 3 (4.0%) were high risk. The median follow-up was 24.0 months (range 6-45 months). During hospitalization and follow-up, no complications, recurrence or metastasis occurred.
Based on our study from a medical centre, ESD is a safe and effective method for treating GISTs. However, further studies are needed.
胃肠道间质瘤（GISTs）是最常见的间叶组织肿瘤。内镜黏膜下剥离术（ESD）多年来一直用于切除黏膜下肿瘤。然而，ESD是否可推荐用于GISTs的治疗仍存在争议。因此，我们评估了ESD治疗GISTs的疗效和安全性。
我们回顾性分析了2016年1月至2018年12月在我院接受ESD的75例GIST患者，并分析了其人口统计学数据、肿瘤临床表现、手术参数、术后并发症及住院时间。
75例患者均成功进行了整块切除，74例（98.7%）患者病变完全切除，肿瘤平均大小为1.7 cm（范围0.3 - 6.0 cm）。中位手术时间为84.8分钟（范围20 - 180分钟）。42例（56.0%）患者进行了内镜荷包缝合，无一例转为开放手术。术后中位住院时间为6.6天（范围3 - 14天）。75例GIST患者中，48例（64.0%）被认为极低风险，19例（25.3%）为低风险，5例（6.7%）为中度风险，3例（4.0%）为高风险。中位随访时间为24.0个月（范围6 - 45个月）。住院期间及随访期间，未发生并发症、复发或转移。
基于我们医学中心的研究，ESD是治疗GISTs的一种安全有效的方法。然而，仍需要进一步研究。
