Endoscopic submucosal tunnel dissection for treatment of large gastric angle superficial neoplasms: a multicenter retrospective study

Abstract

Objective To evaluate the clinical value of endoscopic submucosal tunnel dissection (ESTD) for treatment of large gastric angle superficial neoplasms. Methods A retrospective analysis was performed on data of 87 patients with superfical neoplasms in gastric angle, including 32 cases undergoing ESTD and 55 cases undergoing endoscopic submucosal dissection (ESD) in 6 institutions between July 2014 and July 2016. The dissection time, dissection speed, en bloc resection rate, curative resection rate, adverse events, and prognosis were compared between the two groups. Results The ESTD group showed a shorter dissection time (87.3±32.6 min VS 136.7±64.5 min, P<0.01), a higher dissection speed (0.18±0.07 cm2/min VS 0.08±0.05 cm2/min, P<0.01), a higher en bloc resection rate[100% (32/32) VS 87.3% (48/55), P=0.035], and a higher curative resection rate[100% (32/32) VS 85.5% (47/55), P=0.024] compared with the ESD group. The intraoperative bleeding rate[59.4% (19/32) VS 100.0% (55/55), P<0.01] and muscular injury rate[0 (0/32) VS 14.5% (8/55), P=0.024] were lower in the ESTD group than those of the ESD group. There was no statistical difference on recurrence rate between the two groups[0 (0/32) VS 1.9% (1/54), P=0.443]. Conclusion ESTD has a higher dissection speed and greater security on treatment of large gastric angle superficial neoplasms, and is worthy to be generalized. Key words: Stomach neoplasms; Gastric angle; Endoscopic submucosal tunnel dissection; Endoscopic submucosal dissection; Efficacy; Safety