Lin XM, Peng YM, Zeng HT, Yang JX, Xu ZL. Endoscopic “calabash” ligation and resection for small gastric mesenchymal tumors. World J Gastrointest Endosc 2024; 16(10): 545-556 [PMID: 39473541 DOI: 10.4253/wjge.v16.i10.545]
Corresponding Author of This Article
Zheng-Lei Xu, MD, Assistant Professor, Chief Doctor, Department of Gastroenterology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, No. 1017 Dongmen North Road, Shenzhen 518000, Guangdong Province, China. 78249073@qq.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Xi-Min Lin, Hao-Tian Zeng, Jia-Xing Yang, Department of Gastroenterology, The Second Clinical Medical College, Jinan University, Shenzhen 518000, Guangdong Province, China
Yue-Ming Peng, Department of Nursing, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, Shenzhen 518000, Guangdong Province, China
Zheng-Lei Xu, Department of Gastroenterology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, Shenzhen 518000, Guangdong Province, China
Co-first authors: Xi-Min Lin and Yue-Ming Peng.
Author contributions: Xu ZL conceived the idea for the manuscript and reviewed the manuscript; Lin XM and Peng YM contributed equally to this study and are considered as co-first authors, and they wrote the first draft of the manuscript; Zeng HT and Yang JX searched part of the information.
Supported bythe Sanming Project of Medicine in Shenzhen, No. SZSM202211029.
Institutional review board statement: The study was reviewed and approved by the clinical research ethics committee of Shenzhen People’s Hospital (Approval No. SYLCYJ202116).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zheng-Lei Xu, MD, Assistant Professor, Chief Doctor, Department of Gastroenterology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, No. 1017 Dongmen North Road, Shenzhen 518000, Guangdong Province, China. 78249073@qq.com
Received: June 25, 2024 Revised: August 16, 2024 Accepted: September 5, 2024 Published online: October 16, 2024 Processing time: 111 Days and 15.3 Hours
Abstract
BACKGROUND
Gastric mesenchymal tumors (GMT) are identified as soft tissue neoplasms that arise from mesenchymal stem cells within the gastrointestinal tract. GMT primarily encompass gastric stromal tumors (GST), gastric leiomyomas, and gastric schwannomas. Although most GMT are benign, there are still potential malignant changes, especially GST. Thus, early surgical intervention is the primary treatment for GMT. We have designed a simple endoscopic “calabash” ligation and resection (ECLR) procedure to treat GMT. Its efficacy and safety need to be compared with those of traditional endoscopic techniques, such as endoscopic submucosal excavation (ESE).
AIM
To assess the safety and effectiveness of ECLR in managing small GMT (sGMT) with a maximum diameter ≤ 20 mm by comparing to ESE.
METHODS
This retrospective analysis involved patients who were hospitalized in our institution between November 2021 and March 2023, underwent endoscopic resection, and received a pathological diagnosis of GMT. Cases with a tumor diameter ≤ 20 mm were chosen and categorized into two cohorts: Study and control groups. The study group was composed of patients treated with ECLR, whereas the control group was composed of those treated with ESE. Data on general clinical characteristics (gender, age, tumor diameter, tumor growth direction, tumor pathological type, and risk grade), surgery-related information (complete tumor resection rate, operation duration, hospitalization duration, hospitalization cost, and surgical complications), and postoperative follow-up were collected for both groups. The aforementioned data were subsequently analyzed and compared.
RESULTS
Five hundred and eighty-nine individuals were included, with 297 cases in the control group and 292 in the study group. After propensity score matching, the final analysis incorporated 260 subjects in each cohort. The findings indicated that the study group exhibited shorter operation duration and lowered medical expenses relative to the control group. Furthermore, the study group reported less postoperative abdominal pain and had a lower incidence of intraoperative perforation and postoperative electrocoagulation syndrome than the control group. There were no substantial variations observed in other parameters among the two cohorts.
CONCLUSION
ECLR is a viable and effective approach for managing sGMT.
Core Tip: Geometric mesenchymal tumors (GMT) have a certain malignant tendency. Endoscopic submucosal excavation is commonly used to treat this tumor clinically. We designed a new endoscopic technique [endoscopic “calabash” ligation and resection (ECLR)] to treat the tumor. Studies have shown that ECLR is an effective method for the treatment of GMT.
