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Background <p>Several studies have confirmed the safety and efficacy of endoscopic full-thickness resection (EFTR) of gastric subepithelial lesions (SELs), but many hospitals need to perform EFTR procedures in the operating room.</p> Objective <p>The objective was to evaluate the safety and feasibility of EFTR of large (≥ 3&#xa0;cm) gastric SELs outside the operating room based on our 10&#xa0;years of experience.</p> Methods <p>Patients with large gastric SELs who received EFTR from January 2013 to August 2023 were included. Univariate and multivariate logistic regression analyses were used to explore the risk factors for postoperative fever.</p> Results <p>81 patients were included. The average maximum diameter of tumor was 39.41 ± 9.34&#xa0;mm, and 72 cases (88.9%) achieved en bloc resection. The average procedure time was 89.93 ± 49.80&#xa0;min; no patients had postoperative hemorrhage or perforation. Follow-up showed no recurrence and metastasis. Multivariate regression analysis found that the tumor located in the middle and lower 1/3 of the stomach [odds ratio (OR) 3.208, 95% confidence interval (CI) 1.064–9.674; <i>P</i> = 0.038] and maximum diameter ≥ 39&#xa0;mm (OR 3.136, 95% CI 1.105–8.900,<i> P</i> = 0.032) were risk factors for postoperative fever, while prophylactic antibiotic use (OR 0.249, 95% CI 0.066–0.941, <i>P</i> = 0.040) was a protective factor.</p> Conclusion <p>EFTR of gastric SELs outside the operating room is safe and feasible. Patients with tumors larger than 39&#xa0;mm or in the lower middle third of the stomach are more likely to have postoperative fever, and prophylactic antibiotic use can reduce the risk.</p>

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Feasibility and safety of endoscopic full-thickness resection of large gastric subepithelial lesions outside the operating room: 10 years of experience in a large tertiary hospital in China

  • 期刊论文

  • 发表日期：

    2025年8月8日

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  • Taiyu Chen,
  • Foqiang Liao,
  • Kang Li,
  • Yunfeng Huang,
  • Jianfang Rong,
  • Zhenhua Zhu,
  • Xiaolin Pan,
  • Shunhua Long,
  • Guohua Li,
  • Xiaojiang Zhou,
  • Youxiang Chen,
  • Yin Zhu,
  • Xu Shu

摘要

Background

Several studies have confirmed the safety and efficacy of endoscopic full-thickness resection (EFTR) of gastric subepithelial lesions (SELs), but many hospitals need to perform EFTR procedures in the operating room.

Objective

The objective was to evaluate the safety and feasibility of EFTR of large (≥ 3 cm) gastric SELs outside the operating room based on our 10 years of experience.

Methods

Patients with large gastric SELs who received EFTR from January 2013 to August 2023 were included. Univariate and multivariate logistic regression analyses were used to explore the risk factors for postoperative fever.

Results

81 patients were included. The average maximum diameter of tumor was 39.41 ± 9.34 mm, and 72 cases (88.9%) achieved en bloc resection. The average procedure time was 89.93 ± 49.80 min; no patients had postoperative hemorrhage or perforation. Follow-up showed no recurrence and metastasis. Multivariate regression analysis found that the tumor located in the middle and lower 1/3 of the stomach [odds ratio (OR) 3.208, 95% confidence interval (CI) 1.064–9.674; P = 0.038] and maximum diameter ≥ 39 mm (OR 3.136, 95% CI 1.105–8.900, P = 0.032) were risk factors for postoperative fever, while prophylactic antibiotic use (OR 0.249, 95% CI 0.066–0.941, P = 0.040) was a protective factor.

Conclusion

EFTR of gastric SELs outside the operating room is safe and feasible. Patients with tumors larger than 39 mm or in the lower middle third of the stomach are more likely to have postoperative fever, and prophylactic antibiotic use can reduce the risk.