Tanaka Ippei, Shimamura Yuto, Inoue Haruhiro, Azuma Daisuke, Ushikubo Kei, Yamamoto Kazuki, Okada Hiroki, Nishikawa Yohei, Tanabe Mayo, Onimaru Manabu
Digestive Diseases Center Showa University Koto Toyosu Hospital Tokyo Japan.
DEN Open. 2024 Jul 15;5(1):e402. doi: 10.1002/deo2.402. eCollection 2025 Apr.
Endoscopic resection (ER) for gastric submucosal tumors (SMTs) has gained prominence in recent years, with studies emerging from various countries. However, there is a paucity of reports from Japan. We aimed to elucidate the efficacy and safety of ER for gastric SMT in Japan.
In this retrospective observational study, we investigated the outcomes of consecutive patients who underwent ER for gastric SMT from January 2017 to May 2023. The outcome variables assessed included the complete resection rate, procedure time, closure-related outcomes, and the incidence of adverse events.
A total of 13 patients were included in the analysis. The median procedure time was 163 (55-283) min. Complete full-thickness resection was performed in seven cases, while in four cases, the serosa remained, and in two cases, the outer layer of the muscularis propria remained. In two cases where the SMT was located on the anterior side, conversion to laparoscopic surgery became necessary, resulting in a procedural success rate of 84.6% (11/13). Excluding these two cases, endoscopic closure of the defect was successfully accomplished in the remaining 11 cases. R0 resection was achieved in 12 out of 13 cases (92.3%). Although one patient had peritonitis, which was successfully treated conservatively, no other treatment-related adverse events were encountered.
Although ER for SMT on the anterior side may be challenging, our experience revealed that ER is a safe and efficacious approach for gastric SMT.
近年来，内镜下切除（ER）胃黏膜下肿瘤（SMT）在各国的研究中日益受到关注。然而，来自日本的报道较少。我们旨在阐明在日本ER治疗胃SMT的疗效和安全性。
在这项回顾性观察研究中，我们调查了2017年1月至2023年5月期间连续接受ER治疗胃SMT的患者的结局。评估的结局变量包括完全切除率、手术时间、闭合相关结局和不良事件发生率。
共有13例患者纳入分析。中位手术时间为163（55 - 283）分钟。7例患者实现了全层完整切除，4例患者浆膜层残留，2例患者固有肌层外层残留。2例SMT位于前侧的患者需要转为腹腔镜手术，手术成功率为84.6%（11/13）。排除这2例患者后，其余11例患者成功完成了内镜下缺损闭合。13例患者中有12例（92.3%）实现了R0切除。尽管1例患者发生了腹膜炎，经保守治疗成功治愈，但未遇到其他与治疗相关的不良事件。
尽管前侧SMT的ER可能具有挑战性，但我们的经验表明，ER是治疗胃SMT的一种安全有效的方法。
