Li Ji, Xu Dong, Huang Weifeng, Lei Xiaoyi, Wang Yanqing, Zhang Jinyan
Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
The School of Clinical Medicine, Fujian Medical University, Fuzhou, China.
Ann Med. 2025 Dec;57(1):2514788. doi: 10.1080/07853890.2025.2514788. Epub 2025 Jun 14.
Although endoscopic resection (ER) is an established technique for gastric subepithelial tumours (SETs), comprehensive data on its efficacy and safety remain limited. This study aimed to evaluate the efficacy and safety of ER in patients with gastric SETs and to identify risk factors associated with procedure-related complications.
This retrospective study included 483 patients who underwent ER for gastric SETs between February 2012 and May 2023. Patient demographics, tumour characteristics, and clinical outcomes were evaluated. Multivariate analysis was performed to identify risk factors for complications.
The median tumour size was 1.2 cm (range: 0.5-6.0 cm). The complete resection rate was 93.8%. Complications occurred in 6.8% of cases, including perioperative bleeding (2.1%), perforation (1.7%), and both (0.4%), with 0.8% of cases requiring conversion to surgery. Larger tumours notably increased the risks of incomplete resection (odds ratio [OR] = 1.605, 95% confidence interval [CI]: 1.066-2.416, = 0.023), perioperative bleeding (OR = 2.004, 95% CI: 1.099-3.653, = 0.023), and perforation (OR = 3.476, 95% CI: 1.830-6.602, < 0.001). Additionally, an irregular tumour shape significantly elevated the risk of incomplete resection (OR = 10.771, 95% CI: 3.452-33.605, < 0.001). Conversely, tumours located in the middle third (OR = 0.068, 95% CI: 0.014-0.341, = 0.001) and the upper third (OR = 0.211, 95% CI: 0.051-0.884, = 0.033) of the stomach substantially reduced the risk of incomplete resection.
ER is an effective and generally safe treatment modality for managing gastric SETs. However, larger tumour size and irregular shape are significant risk factors for adverse outcomes.
尽管内镜切除术（ER）是治疗胃黏膜下肿瘤（SETs）的成熟技术，但其疗效和安全性的综合数据仍然有限。本研究旨在评估ER治疗胃SETs患者的疗效和安全性，并确定与手术相关并发症相关的危险因素。
这项回顾性研究纳入了2012年2月至2023年5月期间接受ER治疗胃SETs的483例患者。评估了患者的人口统计学特征、肿瘤特征和临床结局。进行多因素分析以确定并发症的危险因素。
肿瘤大小中位数为1.2 cm（范围：0.5 - 6.0 cm）。完全切除率为93.8%。6.8%的病例发生了并发症，包括围手术期出血（2.1%）、穿孔（1.7%）以及两者都有（0.4%），0.8%的病例需要转为手术治疗。较大的肿瘤显著增加了不完全切除的风险（比值比[OR]=1.605，95%置信区间[CI]：1.066 - 2.416，P = 0.023）、围手术期出血风险（OR = 2.004，95% CI：1.099 - 3.653，P = 0.023）和穿孔风险（OR = 3.476，95% CI：1.830 - 6.602，P < 0.001）。此外，肿瘤形状不规则显著增加了不完全切除的风险（OR = 10.771，95% CI：3.452 - 33.605，P < 0.001）。相反，位于胃中三分之一（OR = 0.068，95% CI：0.014 - 0.341，P = 0.001）和上三分之一（OR = 0.211，95% CI：0.051 - 0.884，P = 0.033）的肿瘤显著降低了不完全切除的风险。
ER是治疗胃SETs的一种有效且总体安全的治疗方式。然而，较大的肿瘤大小和不规则形状是不良结局的重要危险因素。
