Subepithelial tumors: How does endoscopic full-thickness resection & submucosal tunneling with endoscopic resection compare with laparoscopic endoscopic cooperative surgery?

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art_KAHALEH_Subepithelial_tumors_How_does_endoscopic_fullthickness_resection_submucosal_2022.PDF (669.5 KB)
Citações na Scopus
Tipo de produção
article
Data de publicação
2022
DOI
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
GEORG THIEME VERLAG KG
Autores
KAHALEH, Michel
BHAGAT, Vicky
DELLATORE, Peter
TYBERG, Amy
SARKAR, Avik
SHAHID, Haroon M.
ANDALIB, Iman
ALKHIARI, Resheed
GAIDHANE, Monica
KEDIA, Prashant
Citação
ENDOSCOPY INTERNATIONAL OPEN, v.10, n.11, p.E1491-E1496, 2022
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background and study aims Endoscopic techniques are rapidly emerging for resection of subepithelial tumors (SETs). Submucosal tunneling for endoscopic resection (STER), endoscopic full-thickness resection (EFTR) and laparoscopic endoscopic cooperative surgery (LECS) are current alternatives to open surgery. In this study, we aimed to compare the three endoscopic techniques. Patients and methods Consecutive patients who underwent resection of a submucosal esophageal or gastric lesion at several tertiary care centers were included in a dedicated registry over 3 years. Demographics, size and location of resected lesion, histology of specimen, length of procedure, adverse events (AEs), duration of hospital stay, and follow-up data were collected. Results Ninety-six patients were included (47.7 % male, mean age 62): STER n = 34, EFTR n = 34, LECS n = 280. The lesions included leiomyoma, gastrointestinal stromal tumors (GISTs) and other. The mean lesion size was 28 mm (STD 16, range 20-72 mm). The majority of lesions in the EFTR and laparoscopic-assisted resection group were GISTs. There was no significant difference in clear resection margins, post-procedure complication rates, recurrence rate and total follow-up duration between the groups. However, the LECS group had a procedure time at least 30 minutes longer than STER or EFTR ( P < 0.01). Total hospital stay for the laparoscopic-assisted resection group was also longer when compared to STER (1.5) and EFTR (1.8) ( P < 0.01). Conclusions STER, EFTR, and laparoscopic-assisted resection are efficacious approaches for resection of SETs with similar R0 resection rates, complication rates, and AE rates. Laparoscopic assisted resection appears more time-consuming and is associated with a longer hospital stay.
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URI
https://observatorio.fm.usp.br/handle/OPI/50520
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MGT
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/35