PMID- 35724694
OWN - NLM
STAT- MEDLINE
DCOM- 20221025
LR  - 20221105
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 96
IP  - 5
DP  - 2022 Nov
TI  - Endoscopic resection of upper GI extraluminal tumors (with videos).
PG  - 752-763.e6
LID - S0016-5107(22)01771-0 [pii]
LID - 10.1016/j.gie.2022.06.020 [doi]
AB  - BACKGROUND AND AIMS: Endoscopic resection is a feasible treatment for GI 
      extraluminal tumors but remains a challenging procedure with limited data. In 
      this study, we assessed the safety and efficacy of endoscopic resection for 
      extraluminal tumors in the upper GI tract. METHODS: From May 2016 to December 
      2021, 109 patients undergoing endoscopic resection for extraluminal tumors in the 
      upper GI tract were retrospectively included. Clinicopathologic characteristics, 
      procedure-related parameters, adverse events (AEs), and follow-up outcomes were 
      analyzed. RESULTS: The en-bloc tumor resection rate was 94.5% and en-bloc 
      retrieval rate 86.2%. Statistical analysis revealed tumor size >/=3.0 cm and 
      irregular shape as significant risk factors for piecemeal extraction. Resection 
      time and suture time were 46.8 +/- 33.6 minutes and 20.6 +/- 20.1 minutes, 
      respectively. Large tumor size was significantly associated with a longer 
      procedure duration. Five patients (4.6%) experienced major AEs, including 
      recurrent laryngeal nerve injury, hydrothorax, major bleeding, local peritonitis, 
      duodenal leakage, and repeat endoscopic surgery for tumor extraction. Minor AEs 
      occurred in 13 patients (11.9%). Irregular tumor shape and tumor location 
      (duodenum) were significantly associated with AE occurrence. Mean postoperative 
      hospital stay was 4.7 +/- 3.3 days. No recurrence or metastasis was observed during 
      the mean follow-up period of 31.8 +/- 15.2 months. CONCLUSIONS: Endoscopic 
      resection is a safe and feasible therapeutic approach for upper GI extraluminal 
      tumors. Tumor size, shape, and location impact the difficulty and safety of the 
      procedure. Endoscopic resection of duodenal tumors is also feasible but 
      associated with an increased risk of AEs compared with tumors in other locations.
CI  - Copyright (c) 2022 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Ma, Li-Yun
AU  - Ma LY
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China.
FAU - Liu, Zu-Qiang
AU  - Liu ZQ
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China.
FAU - Yao, Lu
AU  - Yao L
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China.
FAU - Xu, Mei-Dong
AU  - Xu MD
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China.
FAU - Chen, Shi-Yao
AU  - Chen SY
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China.
FAU - Zhong, Yun-Shi
AU  - Zhong YS
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China.
FAU - Zhang, Yi-Qun
AU  - Zhang YQ
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China.
FAU - Chen, Wei-Feng
AU  - Chen WF
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China.
FAU - Ma, Li-Li
AU  - Ma LL
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China.
FAU - Qin, Wen-Zheng
AU  - Qin WZ
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China.
FAU - Hu, Jian-Wei
AU  - Hu JW
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China.
FAU - Cai, Ming-Yan
AU  - Cai MY
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China.
FAU - Yao, Li-Qing
AU  - Yao LQ
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China.
FAU - Li, Quan-Lin
AU  - Li QL
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China; Shanghai Collaborative Innovation Center of 
      Endoscopy, Shanghai, China.
FAU - Zhou, Ping-Hong
AU  - Zhou PH
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China; Shanghai Collaborative Innovation Center of 
      Endoscopy, Shanghai, China.
LA  - eng
PT  - Journal Article
DEP - 20220618
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
MH  - Humans
MH  - *Stomach Neoplasms/pathology
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - *Duodenal Neoplasms/surgery
MH  - Endoscopy
EDAT- 2022/06/21 06:00
MHDA- 2022/10/26 06:00
CRDT- 2022/06/20 19:22
PHST- 2022/03/30 00:00 [received]
PHST- 2022/06/05 00:00 [revised]
PHST- 2022/06/08 00:00 [accepted]
PHST- 2022/06/21 06:00 [pubmed]
PHST- 2022/10/26 06:00 [medline]
PHST- 2022/06/20 19:22 [entrez]
AID - S0016-5107(22)01771-0 [pii]
AID - 10.1016/j.gie.2022.06.020 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2022 Nov;96(5):752-763.e6. doi: 10.1016/j.gie.2022.06.020. 
      Epub 2022 Jun 18.