Feasibility and safety of endoscopic resection for duodenal gastrointestinal stromal tumors
Background: Endoscopic resection for duodenal gastrointestinal stromal tumors (GISTs) is still considered a great challenge with a high risk of complications. This study aimed to evaluate the effectiveness and safety of endoscopic resection for duodenal GIST. Methods: Between June 2013 and August 2...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-2655-1439 |
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| Summary: | Background: Endoscopic resection for duodenal gastrointestinal stromal tumors (GISTs) is still considered a great challenge with a high risk of complications. This study aimed to evaluate the effectiveness and safety of endoscopic resection for duodenal GIST.
Methods: Between June 2013 and August 2024, we performed a retrospective study of patients with duodenal GIST who underwent endoscopic resection at Zhongshan Hospital. Data on patient characteristics, clinic outcome, and follow-up were collected.
Results: A total of 73 patients with duodenal GIST were enrolled, including 31 patients with endoscopic submucosal (ESD), and 42 underwent endoscopic full-thickness resection (EFTR). The mean lesion size was 1.2±0.5 cm and 1.7±0.7 cm, respectively. The en bloc resection rate was 96.8% and 95.2%,respectively. The rate of R0 resection was 45.2% and 42.9%, respectively; The rate of R1 resection was 54.8% and 57.1%, respectively. No patient transferred to open surgery. Postoperative adverse events included delayed bleeding (1 case), delayed perforation (1 case), delayed wall edema (2 cases), hydrothorax (1 case) and retroperitoneal infection (1 case). The mean hospital stay was 4.1±2.8 days and 6.2±4.9 days, respectively. No metastasis and duodenal stenosis were detected during the follow-up period (64.8±43.6 months and 61.3±40.2 months, respectively). Local recurrence occurred in one patient with high recurrence risk at 56months after EFTR.
Conclusion: ESD and EFTR are a safe, minimally invasive treatment for duodenal GISTs. Moreover, the EFTR technique may have advantages of completely resecting lesions originating from the deep muscularis propri layer, particularly those lesions with extraluminal growth. |
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| ISSN: | 2364-3722 2196-9736 |