Endoscopic full-thickness resection (EFTR) is difficult to perform in a retroflexed fashion in the gastric fundus. The present study aims at exploring whether direct EFTR can be a simple, effective and safe procedure to treat intraluminal-growth submucosal tumors originating from the muscularis propria. The patients with intraluminal-growth submucosal tumors originating from the muscularis propria in gastric fundus treated by direct EFTR between 01 January 2017 and 01 September 2018 were retrospectively reviewed. In addition, we analyzed the patients with intraluminal-growth submucosal tumors originating from the muscularis propria in gastric fundus treated by traditional EFTR. The differences in tumor resection time, cost-effectiveness, and complication rate were evaluated. Forty patients were enrolled in the present study, 20 patients of which were in the direct EFTR group and 20 patients of which were in the traditional EFTR group. En-bloc resections of gastric tumors were successfully performed in all 40 cases. There was no significant difference in the average tumor size of the two groups (24.3 ± 2.9 mm in direct EFTR group verus 24.0 ± 2.6 mm in the traditional group, p = 0.731), but significant difference existed in the operative time between two groups (35.0 ± 8.2 min in direct EFTR group verus 130.6 ± 51.9 min in the traditional group, p<0.05). No complications, such as postoperative bleeding and perforation, occurred in any groups. Direct EFTR is a safe, simple and cost-effective procedure for SMTs with an intraluminal growth pattern originating from the muscularis propria layer in the gastric fundus.

中文翻译：

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直接内镜全层切除术治疗黏膜下肿瘤，其腔内生长模式起源于胃底的固有肌层

内窥镜全层切除术（EFTR）很难以逆行方式在胃底进行。本研究旨在探讨直接EFTR是否可以作为一种简单，有效和安全的方法来治疗源自固有肌层的腔内生长粘膜下肿瘤。回顾性分析2017年1月1日至2018年9月1日期间接受直接EFTR治疗的胃底固有层肌层腔内黏膜下肿瘤的患者。此外，我们分析了传统EFTR治疗的胃底自胃肌层固有腔内生长的粘膜下肿瘤患者。评估了肿瘤切除时间，成本效益和并发症发生率的差异。本研究招募了40名患者，直接EFTR组为20例，传统EFTR组为20例。在所有40例病例中，大肠胃肿瘤的切除均成功完成。两组的平均肿瘤大小无显着差异（直接EFTR组为24.3±2.9 mm，传统组为24.0±2.6 mm，p = 0.731），但两组之间的手术时间存在显着差异（直接EFTR组为35.0±8.2分钟，而传统组为130.6±51.9分钟，p <0.05）。任何组均未发生并发症，如术后出血和穿孔。对于具有源自胃底固有肌层的腔内生长模式的SMT，直接EFTR是一种安全，简单且具有成本效益的方法。