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Background and aims <p>With the rapid development of endoscopic technology, endoscopic resection (ER) of gastrointestinal stromal tumors (GISTs) has been an alternative therapeutic strategy. However, endoscopic full-thickness resection (EFTR) for GISTs still presents certain technical difficulties and challenges. The study aimed to evaluate the efficacy, safety, and long-term outcomes of EFTR for GISTs in the upper gastrointestinal (UGI) tract.</p> Methods <p>238 patients with UGI GISTs who underwent EFTR from October 2016 to September 2024 were retrospectively enrolled into this study. Clinicopathologic characteristics, procedure-related outcomes, postoperative adverse events, and follow-up results were collected and analyzed.</p> Results <p>The endoscopic complete resection (ER0) and histological complete resection (R0) rates were 99.58% and 95.80%, respectively. The mean tumor size measured under endoscopic evaluation was 17.22 ± 8.36&#xa0;mm (range 4–50&#xa0;mm). The average procedure time was 52.96 ± 38.21&#xa0;min, comprising a resection time of 33.46 ± 26.50&#xa0;min and a wound closure time of 19.50 ± 18.59&#xa0;min. Ten patients (4.20%) experienced major adverse events, including delayed bleeding in one case (0.42%), delayed perforation in one case (0.42%), peritonitis in four cases (1.68%), hydrothorax in three cases (1.26%), and aspiration pneumonia in four cases (1.68%). Besides, thirty-six procedures (15.13%) experienced technical difficulty. The multivariate analysis revealed that procedures performed by non-experts, tumors presenting predominantly extraluminal growth, and tumors with diameters of 20–30&#xa0;mm and ≥ 30&#xa0;mm were independent risk factors for technical difficulty. No patients encountered recurrence and metastasis during the mean follow-up times of 44.15 ± 24.83&#xa0;months.</p> Conclusion <p>EFTR is a safe and effective technique for treating UGI GISTs. Further prospective studies are needed to determine the role of EFTR in treating GISTs.</p>

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Endoscopic full-thickness resection of upper gastrointestinal stromal tumors: a retrospective study from a large tertiary hospital in China

  • 期刊论文

  • 发表日期：

    2026年1月13日

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  • Bitao Lin,
  • Lu Yang,
  • Jingyi Lu,
  • Ruijia Li,
  • Danyi Li,
  • Zhitao Chen,
  • Side Liu,
  • Zelong Han,
  • Yixia Chai

摘要

Background and aims

With the rapid development of endoscopic technology, endoscopic resection (ER) of gastrointestinal stromal tumors (GISTs) has been an alternative therapeutic strategy. However, endoscopic full-thickness resection (EFTR) for GISTs still presents certain technical difficulties and challenges. The study aimed to evaluate the efficacy, safety, and long-term outcomes of EFTR for GISTs in the upper gastrointestinal (UGI) tract.

Methods

238 patients with UGI GISTs who underwent EFTR from October 2016 to September 2024 were retrospectively enrolled into this study. Clinicopathologic characteristics, procedure-related outcomes, postoperative adverse events, and follow-up results were collected and analyzed.

Results

The endoscopic complete resection (ER0) and histological complete resection (R0) rates were 99.58% and 95.80%, respectively. The mean tumor size measured under endoscopic evaluation was 17.22 ± 8.36 mm (range 4–50 mm). The average procedure time was 52.96 ± 38.21 min, comprising a resection time of 33.46 ± 26.50 min and a wound closure time of 19.50 ± 18.59 min. Ten patients (4.20%) experienced major adverse events, including delayed bleeding in one case (0.42%), delayed perforation in one case (0.42%), peritonitis in four cases (1.68%), hydrothorax in three cases (1.26%), and aspiration pneumonia in four cases (1.68%). Besides, thirty-six procedures (15.13%) experienced technical difficulty. The multivariate analysis revealed that procedures performed by non-experts, tumors presenting predominantly extraluminal growth, and tumors with diameters of 20–30 mm and ≥ 30 mm were independent risk factors for technical difficulty. No patients encountered recurrence and metastasis during the mean follow-up times of 44.15 ± 24.83 months.

Conclusion

EFTR is a safe and effective technique for treating UGI GISTs. Further prospective studies are needed to determine the role of EFTR in treating GISTs.