Summary of Cohort Studies on Clinical Outcomes of Endoscopic Full-Thickness Resection (EFTR) of Treatment of Gastric Subepithelial Tumors
Author | Study period | No. of patients | Closure method | Mean tumor size (cm) | Mean operative time (min) | Complete resection rate (%) | Follow-up duration (mo) | Tumor recurrence rate | Complication |
---|---|---|---|---|---|---|---|---|---|
Zhou et al (2011)47 | July 2007 to January 2009 | 26 | Metallic clips | 2.8 (1.2–4.5) | 105 (60–145) | 100 | 8 (6–24) | No lesion residual or recurrence | None of the studied patients had peritonitis or abdominal abscess. |
Ye et al (2014)48 | January 2009 to December 2012 | 51 | Clips with endoloop | 2.4 (1.3–3.5) |
52 (30–125) |
98.0 | 22.4 (1–48) |
No residual tumor or tumor recurrence | No patients had severe complications, such as massive bleeding, delayed bleeding, peritonitis, or gastrointestinal tract leakage. |
Feng et al (2014)49 | November 2009 to October 2012 | 48 | Metallic clips | 1.59 (0.50–4.80) | 59.72 (30–270) | 100 | 11.8 (2–48) | No recurrence | No post-EFR complication, such as bleeding and peritonitis, was observed. |
Huang et al (2014)50 | January 2010 to September 2013 | 35 | Metallic clips | 2.8 (2.0–4.5) | 90 (60–155) | 100 | 6 mo for all patients | No residual lesion, no recurrence | No gastric bleeding, peritonitis or abdominal abscess occurred |
Yang et al (2015)51 | June 2012 to April 2014 | 41 | -35 patients with metallic clips | 1.63 ± 0.59 | 78.82 ± 46.44 | 100 | Not applicable | Not assessed | No severe complications such as peritonitis, digestive tract hemorrhage, or local infection |
-6 patients with the over-the-scope clip, i.e., OTSC system | |||||||||
Guo et al (2015)52 | October 2013 to March 2014 | 23 | OTSC system | 1.21 (0.6–2.0) | 40.5 (16–104) | 100 | 3 (1–6) | No residual lesion, no recurrence | No postoperative bleeding or perforation |
Schmidt et al (2015)53 | January 2007 to February 2014 | 31 | -29 patients, with the Plicator suturing device | 2.05 (0.8–4.8) | 60.0 (39–229) | 90.3 | 7.1 (0–58) | No recurrence | -12 (38.7%) bleeding |
-2 patients with the GERDX suturing device | -3 (9.6%) perforations | ||||||||
Lu et al (2016)54 | January 2013 to March 2015 | 62 | Metallic clips | 0.6–6.0 | 25–180 | 98.4 | 1–24 | No recurrence | No peritonitis |
Shi et al (2017)55 | April 2014 to February 2015 | 68 | Metallic clips with endoloops | 2.6 (2.0–3.5) | 41 (23–118) | 100 | 7 (3–13) | No residual tumor, no recurrence | -1 (1.5%) Mallory–Weiss syndrome |
-1 (1.5%) delayed bleeding | |||||||||
Duan et al (2018)56 | April 2011 to May 2016 | 28 | Metallic clips | 1.53 ± 0.7 | 63.3 ± 24.4 | 100 | 22.8 ± 18.4 | No recurrence | -1 (3.6%) delayed bleeding |
Shichijo et al (2019)57 | January 2016 to December 2018 | 8 | -3 clip-and-endoloop purse-string suturing | 2.0 (1.0–3.5) |
67.5 (50–166) |
100% En-bloc resection, but 5/8 (62.5%) had indeterminate resection margins histologically | Not applicable | Not assessed | No ≥ CTCAE grade 2 adverse events |
-2 simple endoclipping | |||||||||
-1 OTSC system |
Values are presented as mean (range) or mean ± standard deviation.
EFR, endoscopic full-thickness resection; OTSC, over-the-scope clip; CTCAE, Common Terminology Criteria for Adverse Events (ver. 5.0; released on 2017).
*Median (range).