Cutting edge of endoscopic full-thickness resection for gastric tumor

Table 1 Representative publications reporting endoscopic full-thickness resection for upper gastrointestinal tumors

Ref.	n	Mean operationtime (min)	Mean tumordiameter (mm)	Complete resectionrate (%)	Complicationrate (%)
Zhou et al[8]	26	105	28	100	0
Feng et al[15]	48	60	16	100	0
Huang et al[16]	35	90	28	100	0
Schmidt et al[17]	31	60	20.5	90.3	9.7 (perforation)
Guo et al[9]	23	40.5	12.1	100	0

Table 2 Comparison of each procedure

	Instruments	Indication forEGC	Retrieval route	Intentional gastricperforation	Advantage	Limitation
EFTR	Endoscopy only	No	Transroral	Required	Simple methods using intraluminal endoscopy only	Risk of contamination, endoscopic skills required
Classical LECS	Endoscopy = laparoscopy	No	Transabdominal	Required	Accurate to determine the resection line, laparoscopic assistance	Risk of contamination Risk of contact to tumor surface
Inverted LECS	Endoscopy = laparoscopy	Indefinite	Transoral	Required	Accurate to determine the resection line, laparoscopic assistance	Risk of contact to cancer surface, tumor size
CLEAN-NET	Endoscopy < laparoscopy	Yes	Transabdominal	Not required	No transluminal communication	Excessive resection of the mucosa, difficult to determine the resection line
NEWS	Endoscopy = laparoscopy	Yes	Transoral	Not required	Accurate to determine the resection line, laparoscopic assistance, no transluminal communication	Tumor size, experience required, time-consuming

EFTR: Endoscopic full-thickness resection; LECS: Laparoscopic and endoscopic cooperative surgery; CLEAN-NET: Combination of laparoscopic and endoscopic approaches to neoplasia with a nonexposure technique; NEWS: Nonexposed endoscopic wall-inversion surgery; EGC: Early gastric cancer.