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. 2024 Jul 15;5(1):e402.
doi: 10.1002/deo2.402. eCollection 2025 Apr.

Endoscopic resection for gastric submucosal tumors: A single-center experience in Japan

Ippei Tanaka  1 , Yuto Shimamura  1 , Haruhiro Inoue  1 , Daisuke Azuma  1 , Kei Ushikubo  1 , Kazuki Yamamoto  1 , Hiroki Okada  1 , Yohei Nishikawa  1 , Mayo Tanabe  1 , Manabu Onimaru  1
Affiliations

Endoscopic resection for gastric submucosal tumors: A single-center experience in Japan

Ippei Tanaka et al. DEN Open. .

Abstract

Objectives: Endoscopic resection (ER) for gastric submucosal tumors (SMTs) has gained prominence in recent years, with studies emerging from various countries. However, there is a paucity of reports from Japan. We aimed to elucidate the efficacy and safety of ER for gastric SMT in Japan.

Methods: In this retrospective observational study, we investigated the outcomes of consecutive patients who underwent ER for gastric SMT from January 2017 to May 2023. The outcome variables assessed included the complete resection rate, procedure time, closure-related outcomes, and the incidence of adverse events.

Results: A total of 13 patients were included in the analysis. The median procedure time was 163 (55-283) min. Complete full-thickness resection was performed in seven cases, while in four cases, the serosa remained, and in two cases, the outer layer of the muscularis propria remained. In two cases where the SMT was located on the anterior side, conversion to laparoscopic surgery became necessary, resulting in a procedural success rate of 84.6% (11/13). Excluding these two cases, endoscopic closure of the defect was successfully accomplished in the remaining 11 cases. R0 resection was achieved in 12 out of 13 cases (92.3%). Although one patient had peritonitis, which was successfully treated conservatively, no other treatment-related adverse events were encountered.

Conclusions: Although ER for SMT on the anterior side may be challenging, our experience revealed that ER is a safe and efficacious approach for gastric SMT.

Keywords: endoscopic full‐thickness resection; endoscopic muscularis dissection; endoscopic resection; endoscopic subserosal dissection; gastric submucosal tumors.

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Conflict of interest statement

Author Haruhiro Inoue is an advisor for Olympus Corporation and Top Corporation. He has also received educational grants from Olympus Corporation and Takeda Pharmaceutical Co. The other authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Representative case of endoscopic full‐thickness resection. (a) A submucosal tumor measuring 25 mm in size was located at the greater curvature of the lower gastric body. (b) Endoscopic ultrasonography showed a low echoic mass mixed with a slightly high echoic area, situated at the muscle layer. The lesion was suspected of a gastrointestinal tumor. (c) After the submucosal injection of hyaluronic acid, mucosal incision, and submucosal dissection was performed and the tumor was clearly seen. (d) Snare traction method was applied. (e) The defect after the tumor resection. (f) Loop11 closure method was applied to the large defect. (g) The defect was completely closed. (h) Two months after the procedure, the defect almost became scar.
FIGURE 2
FIGURE 2
Schema of endoscopic submucosal dissection (ESD), endoscopic muscle dissection (EMD), endoscopic subserosa dissection (ESSD), and endoscopic full‐thickness resection (EFTR).
FIGURE 3
FIGURE 3
(a) Schema of Loop9. (b) Schema of Loop11.
See this image and copyright information in PMC

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