Liapis Stavros Chrysovalantis, Baloyiannis Ioannis, Perivoliotis Konstantinos, Lytras Dimitrios, Tzovaras George
Department of Surgery, "Achillopouleion" General Hospital, Polymeri 134, 38222, Volos, Greece.
Department of Surgery, University Hospital of Larissa, Larissa, Greece.
J Gastrointest Cancer. 2025 Apr 29;56(1):110. doi: 10.1007/s12029-025-01235-7.
Submucosal tunneling endoscopic resection (STER) is an advanced endoscopic technique used for the minimally invasive removal of subepithelial lesions of the gastrointestinal (GI) tract. The aim of this study was to evaluate the safety and efficacy of STER for upper gastrointestinal subepithelial lesions.
A comprehensive search of major scholar databases (until December 15, 2023) was performed. Complete resection rate was considered the primary outcome. En bloc resection, operation duration, length of stay (LOS), local recurrence, and periprocedural complications were considered secondary outcomes. Random-effects (RE) and fixed-effects (FE) models were used to generate the outcome estimates.
A total of 37 studies and 3795 patients were included. Pooled proportion of complete resection was 99% (95% CI 98.4-99.6%, p < 0.001). En bloc resection was achieved at 87.7% of cases. Overall mean operation duration was 64.2 min, while mean LOS was estimated at 4.93 days. The local recurrence rate was 0.1%. The two most common complications associated with STER were subcutaneous emphysema (5.5%) and pneumothorax (3%).
STER is a highly feasible and safe treatment modality for upper GI subepithelial lesions.
黏膜下隧道内镜切除术（STER）是一种先进的内镜技术，用于微创切除胃肠道（GI）的上皮下病变。本研究的目的是评估STER治疗上消化道上皮下病变的安全性和有效性。
对主要学术数据库进行全面检索（截至2023年12月15日）。完全切除率被视为主要结局。整块切除、手术时长、住院时间（LOS）、局部复发和围手术期并发症被视为次要结局。采用随机效应（RE）和固定效应（FE）模型来生成结局估计值。
共纳入37项研究和3795例患者。完全切除的合并比例为99%（95%CI 98.4-99.6%，p＜0.001）。87.7%的病例实现了整块切除。总体平均手术时长为64.2分钟，而平均住院时间估计为4.93天。局部复发率为0.1%。与STER相关的两种最常见并发症是皮下气肿（5.5%）和气胸（3%）。
STER是治疗上消化道上皮下病变的一种高度可行且安全的治疗方式。
