Scholarlink

Background and aims <p>Endoscopic resection has emerged as a viable option for cardial submucosal tumors (SMTs), but existing evidence remains limited by small sample sizes. This study aimed to evaluate the efficacy and safety of endoscopic resection techniques for cardial SMTs more than 30&#xa0;mm in diameter.</p> Methods <p>Between January 2012 and October 2024, 107 patients with cardial SMTs larger than 30&#xa0;mm were included in this study. Data on patient characteristics, clinical outcomes, and follow-up ‌were retrospectively analyzed.</p> Results <p>Among 107 patients, 42 patients underwent submucosal tunneling endoscopic resection (STER), 34 patients underwent endoscopic full-thickness resection (EFTR), and 31 patients received endoscopic submucosal dissection (ESD). The mean lesion size was 4.2 ± 1.9&#xa0;cm. The rate of en bloc resection and complete resection were 94.3% and 91.6%, respectively. Postoperative adverse events included delayed bleeding (2 cases), delayed perforation (2 cases), subcutaneous emphysema (2 cases) and pleural effusion (2 cases). One case of recurrence was detected during the mean follow-up period of 37.4 ± 22.5&#xa0;months. Multivariate analysis showed irregular morphology (OR 2.076, 95% CI 0.513–6.274, <i>P</i> = 0.039) and invasion into the muscularis propria layer (OR 6.157, 95% CI1.160–7.602, <i>P</i> = 0.031) were independent risk factors for incomplete resection; lesion size ≥ 40&#xa0;mm (OR 6.271,&#xa0;95% CI&#xa0;1.024–7.856, <i>P</i> = 0.027), irregular morphology (OR 4.734, 95% CI 1.489–6.052, <i>P</i> = 0.042), trans-cardia tumor (OR 5.526, 95% CI 1.160–7.602, <i>P</i> = 0.043) and invasion into the muscularis propria layer (OR 5.104, 95% CI 1.893–7.965, <i>P</i> = 0.030) were independent risk factors for long operative times.</p> Conclusion <p>Endoscopic resection is an effective and safe treatment for cardial SMTs larger than 30&#xa0;mm, particularly when performed by experienced endoscopists. Long-term surveillance remains crucial for early detection of recurrence.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Feasibility and safety of endoscopic resection for cardial submucosal tumors more than 30 mm in diameter

  • 期刊论文

  • 发表日期：

    2025年9月15日

查看全文
  • Shao-Bin Luo,
  • Zu-Qiang Liu,
  • Li Wang,
  • Yi-Qun Zhang,
  • Ming-Yan Cai,
  • Quan-Lin Li,
  • Ping-Hong Zhou

摘要

Background and aims

Endoscopic resection has emerged as a viable option for cardial submucosal tumors (SMTs), but existing evidence remains limited by small sample sizes. This study aimed to evaluate the efficacy and safety of endoscopic resection techniques for cardial SMTs more than 30 mm in diameter.

Methods

Between January 2012 and October 2024, 107 patients with cardial SMTs larger than 30 mm were included in this study. Data on patient characteristics, clinical outcomes, and follow-up ‌were retrospectively analyzed.

Results

Among 107 patients, 42 patients underwent submucosal tunneling endoscopic resection (STER), 34 patients underwent endoscopic full-thickness resection (EFTR), and 31 patients received endoscopic submucosal dissection (ESD). The mean lesion size was 4.2 ± 1.9 cm. The rate of en bloc resection and complete resection were 94.3% and 91.6%, respectively. Postoperative adverse events included delayed bleeding (2 cases), delayed perforation (2 cases), subcutaneous emphysema (2 cases) and pleural effusion (2 cases). One case of recurrence was detected during the mean follow-up period of 37.4 ± 22.5 months. Multivariate analysis showed irregular morphology (OR 2.076, 95% CI 0.513–6.274, P = 0.039) and invasion into the muscularis propria layer (OR 6.157, 95% CI1.160–7.602, P = 0.031) were independent risk factors for incomplete resection; lesion size ≥ 40 mm (OR 6.271, 95% CI 1.024–7.856, P = 0.027), irregular morphology (OR 4.734, 95% CI 1.489–6.052, P = 0.042), trans-cardia tumor (OR 5.526, 95% CI 1.160–7.602, P = 0.043) and invasion into the muscularis propria layer (OR 5.104, 95% CI 1.893–7.965, P = 0.030) were independent risk factors for long operative times.

Conclusion

Endoscopic resection is an effective and safe treatment for cardial SMTs larger than 30 mm, particularly when performed by experienced endoscopists. Long-term surveillance remains crucial for early detection of recurrence.