A multicenter retrospective study of endoscopic submucosal tunnel dissection for large lesser gastric curvature superficial neoplasms

作者：Zhang, Xing; Shi, Dongtao; Yu, Zhuwen; Li, Rui^*; Chen, Weichang; Bai, Feihu; Wu, Xudong; Cheng, Cuie; Shi, Ruihua; Liu, Pengfei

来源：Surgical Endoscopy and Other Interventional Techniques, 2019, 33(6): 1910-1919.

DOI：10.1007/s00464-018-6471-y

• Early cancer
• Lesser gastric curvature
• Endoscopic submucosal dissection
• Endoscopic submucosal tunnel dissection

Background and aimEndoscopic submucosal tunnel dissection (ESTD) has been used for dissection of esophageal and gastric lesions. However, outcomes of ESTD for large lesions in the lesser gastric curvature had not been acknowledged because previous reports had the limitations of being single-center studies. We aimed to clarify the outcomes of ESTD for large lesser gastric curvature superficial neoplasms and provide our experience to accelerate its application.MethodsBetween July 2014 and July 2016, 87 patients with early cancer in the lesser gastric curvature treated at six Chinese institutions were enrolled. Our primary outcome was dissection speed. Moreover, both efficacy and safety clinical data were collected and analyzed retrospectively.ResultsAll of the 87 patients were found to successfully undergo ESTD or ESD. Of these, 32 underwent ESTD and 55 underwent endoscopic submucosal dissection (ESD). The ESTD group had a higher dissection speed (18.0mm(2)/min vs. 7.8mm(2)/min, p<0.01) and was associated with higher en bloc resection rate (100% vs. 87.3%, p=0.035) and curative resection rate (100% vs. 85.5%, p=0.024) compared with the ESD group. No perforation or muscular injury occurred in the ESTD group and its intraprocedural bleeding rate was lower (59.4% vs. 100%, p<0.01) than that of the ESD group.ConclusionsIn this multicenter retrospective study, outcomes of ESTD were excellent with a higher dissection speed and radical curative rate compared with ESD.

• 出版日期2019-6
• 单位苏州大学; 宁夏回族自治区人民医院; 东南大学