Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
BMC Gastroenterol. 2022 Apr 11;22(1):182. doi: 10.1186/s12876-022-02256-3.
Up till now, there are still controversies about the specific indication of endoscopic resection for small gastric subepithelial tumors (gSETs) originating from muscularis propria. We aimed to investigate the safety of endoscopic resection and postoperative pathology analysis.
The patients with primary small gSETs originating from muscularis propria, treated by endoscopic resection in the endoscopic center of Shengjing Hospital between January, 2011 and September, 2019 were enrolled. The complete resection rate, adverse events and clinicopathological features were recorded.
A total of 936 patients with 972 gastric SETs ≤ 2 cm originating from muscularis propria were included in our study. All the lesions were successfully treated by endoscopic resection. Nearly half of lesions were proved to be gastrointestinal stromal tumor (GIST) [n = 411 (42.3%)] according to postoperative pathology. All the objects were further subdivided into 2 groups, ≤ 1 cm, > 1 and ≤ 2 cm gSETs. The risk of gastric GIST of intermediate/high risk in the group (> 1 and ≤ 2 cm gSETs) is 8.41 times as that of gastric GIST in the group (the size of gastric ≤ 1 cm gSETs) (P < 0.05).
Endoscopic resection is a safe and effective treatment for small gSETs. gSETs (1-2 cm) is more risky than gSETs (≤ 1 cm) and should be resected. This should be evaluated by further studies.
目前对于起源于固有肌层的小胃黏膜下肿瘤（gSETs）行内镜下切除的具体适应证仍存在争议。本研究旨在探讨内镜下切除的安全性和术后病理分析。
回顾性分析 2011 年 1 月至 2019 年 9 月在我院内镜中心行内镜下切除的起源于固有肌层的直径≤2 cm 的小 gSETs 患者的临床资料。记录完全切除率、不良事件和临床病理特征。
共纳入 936 例 972 个直径≤2 cm 起源于固有肌层的胃 SETs，均成功行内镜下切除。术后病理提示近一半（411 个，42.3%）为胃肠道间质瘤（GIST）。所有患者进一步分为 2 组，直径≤1 cm 和>12 cm gSETs。直径>12 cm gSETs 组胃 GIST 中高危风险的发生风险是直径≤1 cm gSETs 组的 8.41 倍（P<0.05）。
内镜下切除是治疗小 gSETs 的安全、有效的方法。直径为 1~2 cm 的 gSETs 比直径≤1 cm 的 gSETs 风险更高，应行内镜下切除，这需要进一步的研究评估。
