Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Department of Gastroenterology, Changshu Hospital Affiliated to Soochow University, Suzhou, China.
Minim Invasive Ther Allied Technol. 2023 Jun;32(3):112-118. doi: 10.1080/13645706.2023.2186182. Epub 2023 Mar 13.
Endoscopic full-thickness resection (EFTR) is a standard treatment method for gastric gastrointestinal stromal tumors (gGISTs). Evidence of the safety and efficacy of a double-curved endoscope (DCE) in EFTR of gGISTs is limited. We aimed to compare the operative outcomes of DCE versus single-curved endoscopes (SCE) in EFTR of gGISTs.
This retrospective observational study was conducted at four Chinese tertiary institutes. From January 2019 to November 2021, 104 patients who underwent EFTR by SCE ( = 57) or DCE ( = 47) were enrolled. One-to-one propensity score matching (PSM) was performed between the two groups to compare the demographics and operative outcomes.
All gGISTs were resected successfully with no recurrence during follow-up. The median (range) tumor size was 1.2 (0.5, 3.5) cm in DCE and 2.0 (0.6, 4.8) cm in SCE ( < .001), and the procedure time was shorter in the DCE group than in the SCE group (50.0 min vs. 62.0 min, < .05). After PSM, 41 pairs were selected, and no difference was noted in demographics. The procedure time was also shorter in the DCE group than in the SCE group (50.0 min vs. 55.0 min, < .05). Subgroup analysis showed that the DCE group had a shorter procedure time in the gastric fundus than the SCE group (47.0 min vs. 55.0 min, < .05). In multiple linear regression analysis, significant factors related to prolonged procedure time were the type of endoscope of SCE and larger tumor size ( < .05).
EFTR of gGISTs using DCE is safe and effective. Compared with SCE, DCE had an advantage in terms of operative time, especially in the gastric fundus.
内镜全层切除术（EFTR）是胃胃肠间质瘤（gGIST）的标准治疗方法。双曲内镜（DCE）在 gGIST 的 EFTR 中的安全性和有效性的证据有限。我们旨在比较 DCE 与单曲内镜（SCE）在 gGIST 的 EFTR 中的手术结果。
这是一项在中国四家三级医院进行的回顾性观察研究。从 2019 年 1 月至 2021 年 11 月，纳入了 104 例接受 SCE（ = 57）或 DCE（ = 47）行 EFTR 的患者。对两组患者进行了 1:1 倾向评分匹配（PSM），以比较两组患者的一般资料和手术结果。
所有 gGIST 均成功切除，随访期间无复发。DCE 组肿瘤大小的中位数（范围）为 1.2（0.5，3.5）cm，SCE 组为 2.0（0.6，4.8）cm（ < .001），DCE 组的手术时间短于 SCE 组（50.0 min 比 62.0 min， < .05）。PSM 后，选择了 41 对，两组患者的一般资料无差异。DCE 组的手术时间也短于 SCE 组（50.0 min 比 55.0 min， < .05）。亚组分析显示，DCE 组胃底部的手术时间短于 SCE 组（47.0 min 比 55.0 min， < .05）。多元线性回归分析显示，延长手术时间的显著因素为 SCE 内镜类型和肿瘤较大（ < .05）。
使用 DCE 行 gGIST 的 EFTR 是安全有效的。与 SCE 相比，DCE 在手术时间方面具有优势，尤其是在胃底部。
