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.

中文翻译：

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上消化道腔外肿瘤的内镜切除术（附视频）

背景和目标

内镜下切除是治疗胃肠道腔外肿瘤的可行方法，但由于数据有限，仍是一项具有挑战性的手术。在这项研究中，我们评估了内镜下切除上消化道管腔外肿瘤的安全性和有效性。

方法

2016 年 5 月至 2021 年 12 月，回顾性纳入 109 例因上消化道腔外肿瘤行内镜下切除术的患者。分析了临床病理学特征、手术相关参数、不良事件 (AE) 和随访结果。

结果

整块肿瘤切除率为94.5%，整块切除率为86.2%。统计分析显示肿瘤大小≥3.0 cm 和不规则形状是分段提取的重要危险因素。切除时间和缝合时间分别为 46.8 ± 33.6 分钟和 20.6 ± 20.1 分钟。较大的肿瘤大小与较长的手术持续时间显着相关。5 名患者 (4.6%) 出现严重不良反应，包括喉返神经损伤、胸水、大出血、局部腹膜炎，十二指肠渗漏，并重复内镜手术进行肿瘤提取。13 名患者 (11.9%) 发生轻微 AE。不规则的肿瘤形状和肿瘤位置（十二指肠）与 AE 的发生显着相关。术后平均住院时间为 4.7 ± 3.3 天。在 31.8 ± 15.2 个月的平均随访期内，未观察到复发或转移。

结论

内镜下切除是上消化道腔外肿瘤安全可行的治疗方法。肿瘤大小、形状和位置会影响手术的难度和安全性。十二指肠肿瘤的内镜切除也是可行的，但与其他部位的肿瘤相比，AEs 的风险增加。