The efficacy of full-thickness endoscopic resection of subepithelial tumors in the gastric cardia

Table 1 Baseline characteristics of the 171 patients with submucosal tumors in gastric cardia treated by endoscopic full-thickness resection and submucosal tunneling endoscopic resection

Patients	EFTR	STER	P value
Age (yr)			0.59
mean ± SD	51.32 ± 12.44	50.29 ± 12.19
Median (range)	52.00 (43.00-61.00)	51.00 (41.00-59.75)
Sex			0.01
Male	24 (33.8%)	53 (53.0%)
Female	47 (66.2%)	47 (47.0%)
Lesion characteristics
Size (cm)			0.78
mean ± SD	2.16 ± 1.81	2.09 ± 1.38
Median (range)	1.50 (1.00-3.00)	1.50 (1.20-2.50)
Extraluminal growth			0.37
Yes	6 (8.5%)	5 (5.0%)
No	65 (91.5%)	95 (95.0%)
Operator level			0.74
Experts	59 (83.1%)	85 (85.0%)
Trainees	12 (16.9%)	15 (15.0%)

EFTR: Endoscopic full-thickness resection; STER: Submucosal tunneling endoscopic resection.

Table 2 A comparison of treatment outcomes between endoscopic full-thickness resection and submucosal tunneling endoscopic resection groups

Outcomes	EFTR	STER	P value
En bloc resection	71 (100%)	97 (97.0%)	0.14
Complete resection	70 (98.6%)	91 (91.0%)	0.04
Procedure time (min)	44.63 ± 28.66	53.36 ± 27.34	0.04
Procedure-related characteristics
Suturing methods			0.01
Metallic clips	38 (53.5%)	98 (98.0%)
Metallic clips with endoloop	29 (40.8%)	2 (2.0%)
Stent	4 (5.6%)	0 (0%)
Histopathology			0.01
GIST	28 (39.4%)	7 (7.0%)
Leiomyoma	43 (60.6%)	88 (88.0%)
Others	0 (0%)	5 (5.0%)
Complications	15 (21.1%)	21 (22.0%)	0.89
Pneumoperitoneum	0 (0%)	0 (0%)
Hydrothorax
Minor hydrothorax	3 (4.2%)	4 (4.0%)
Major hydrothorax	0 (0%)	0 (0%)
PEECS	10 (14.1%)	18 (18.0%)
Delayed bleeding	2 (2.8%)	0 (0%)
Delayed perforation	0 (0%)	0 (0.0%)
Follow-up
Recurrence	0 (0%)	0 (0%)
Metastasis	0 (0%)	0 (0%)

EFTR: Endoscopic full-thickness resection; STER: Submucosal tunneling endoscopic resection; GIST: Gastrointestinal stromal tumor; PEECS: Post-endoscopic submucosal dissection electrocoagulation syndrome.

Table 3 The association of the clinicopathological characteristics of subepithelial tumors in gastric cardia treated by endoscopic full-thickness resection over the median procedure time

	Univariate analysis		Multivariate analysis
	OR (95%CI)	P value	OR (95%CI)	P value
Age (yr)		0.37
< 50	1 (reference)
≥ 50	1.88 (0.48-7.46)
Sex		0.41
Male	1 (reference)
Female	1.76 (0.46-6.68)
Size (cm)		0.01
< 2.0	1 (reference)		1 (reference)	0.02
≥ 2.0	6.58 (1.60-27.09)		3.75 (1.21-11.58)
Extraluminal growth		0.048		0.04
No	1 (reference)		1 (reference)
Yes	7.83 (1.02-60.03)		7.64 (1.15-50.83)
Histopathology		0.42
Others	1 (reference)
Leiomyoma	1.85 (0.42-8.17)
Metallic clips with endoloop		0.05
No	1 (reference)
Yes	3.68 (0.98-13.91)
Operator level		0.19
Trainees	1 (reference)
Experts	0.31 (0.05-1.76)

OR: Odds ratio; 95%CI: 95% confidence interval.