Comparison of endoscopic full-thickness resection and cap-assisted endoscopic full-thickness resection in the treatment of small (≤1.5 cm) gastric GI stromal tumors

Yang, Jinping; Ni, Muhan; Jiang, Jingwei; Ren, Ximei; Zhu, Tingting; Cao, Shouli; Hassan, Shahzeb; Lv, Ying; Zhang, Xiaoqi; Wei, Yongyue; Wang, Lei; Xu, Guifang

doi:10.1016/j.gie.2021.10.026

Cited by 15 publications

(4 citation statements)

References 43 publications

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“…T O PROVIDE ROBUST data on EFTR safety and outcomes, we conducted a brief meta-analysis, including published randomized controlled trials, nonrandomized concurrent controlled trials, case-control studies, cohort studies and serial case reports (>10 cases), [35][36][37][38][39][40][41][42][43][44][45][46][47][48][49] for GI SMTs, during which the number of publications witnessed booming.…”

Section: Device-assisted Eftrmentioning

confidence: 99%

Endoscopic full‐thickness resection, indication, methods and perspectives

Wang

Gao

Cai

et al. 2022

Digestive Endoscopy

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Minimally invasive surgery has emerged as the dominant theme of modern surgery, in which endoscopic surgery plays a key role. The technique of endoscopic surgery has evolved continuously with extensive research, improving the treatment modalities as well as expanding the indications for its use. As an active perforation endoscopic technique, endoscopic fullthickness resection (EFTR) is mainly used in the treatment of submucosal tumors (SMTs) of the gastrointestinal tract. With decades of evolution, EFTR has gradually developed into a mature endoscopic operation. Based on clinical experience and current research, indications, techniques, clinical outcomes and future perspectives for EFTR are discussed in this paper. We performed a bibliometric study on EFTR literature and showed robust data through a brief meta-analysis on the topic.

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Section: Device-assisted Eftrmentioning

confidence: 99%

Endoscopic full‐thickness resection, indication, methods and perspectives

Wang

Gao

Cai

et al. 2022

Digestive Endoscopy

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“…81 Clip in line traction method, cap-assisted technique (in small GIST < 1.5 cm) and direct EFTR (for gastric fundal SELs with intraluminal growth pattern) can reduce the operating time. [82][83][84][85] Snare-assisted EFTR was shown to be cost effective compared with band ligation-assisted or ESD-assisted EFTR with similar efficacy and complication rates. 86 Omental patch, suturing device, or endoscopic loop ligation can be used for defect closure.…”

Section: Ftrd Gist and Other Subepithelial Lesionsmentioning

confidence: 96%

Endoscopic Full Thickness Resection: A Systematic Review

Pal

Ramchandani

Inavolu

et al. 2022

Journal of Digestive Endoscopy

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Background Endoscopic full thickness resection (EFTR) is an emerging therapeutic option for resecting subepithelial lesions (SELs) and epithelial neoplasms. We aimed to systematically review the techniques, applications, outcomes, and complications of EFTR. Methods A systematic literature search was performed using PubMed. All relevant original research articles involving EFTR were included for the review along with case report/series describing novel/rare techniques from 2001 to February 2022. Results After screening 7,739 citations, finally 141 references were included. Non-exposed EFTR has lower probability of peritoneal contamination or tumor seeding compared with exposed EFTR. Among exposed EFTR, tunneled variety is associated with lower risk of peritoneal seeding or contamination compared with non-tunneled approach. Closure techniques involve though the scope (TTS) clips, loop and clips, over the scope clips (OTSC), full thickness resection device (FTRD), and endoscopic suturing/plicating/stapling devices. The indications of EFTR range from esophagus to rectum and include SELs arising from muscularis propria (MP), non-lifting adenoma, recurrent adenoma, and even early gastric cancer (EGC) or superficial colorectal carcinoma. Other indications include difficult locations (involving appendicular orifice or diverticulum) and full thickness biopsy for motility disorders. The main limitation of FTRD is feasibility in smaller lesions (<20–25 mm), which can be circumvented by hybrid EFTR techniques. Oncologic resection with lymphadencetomy for superficial GI malignancy can be accomplished by hybrid natural orifice transluminal endoscopic surgery (NOTES) combining EFTR and NOTES. Bleeding, perforation, appendicitis, enterocolonic fistula, FTRD malfunction, peritoneal tumor seeding, and contamination are among various adverse events. Post OTSC artifacts need to be differentiated from recurrent/residual lesions to avoid re-FTRD/surgery. Conclusion EFTR is safe and effective therapeutic option for SELs, recurrent and non-lifting adenomas, tumors in difficult locations and selected cases of superficial GI carcinoma.

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“…It has been shown that[ 31 ] double-curved endoscope has an advantage over single-curved endoscopes in the duration of EFTR surgery in gGISTs, especially in the fundus of the stomach. Yang et al [ 32 ] found that the treatment outcome, AEs, hospital stay and postoperative recovery of patients with GIST in the group of cap-assisted EFTR were better than those in the group of EFTR, which may be the first choice for small (≤ 1.5 cm) gastric GIST. The new no-touch EFTR technique developed by Chen et al [ 33 ] is a feasible approach for GIST resection and holds promise for complete radical resection.…”

Section: Eftrmentioning

confidence: 99%

Present situation of minimally invasive surgical treatment for early gastric cancer

Li,

Wang,

Luo

et al. 2024

World J Gastrointest Oncol

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Minimally invasive surgery is a kind of surgical operation, which is performed by using professional surgical instruments and equipment to inactivate, resect, repair or reconstruct the pathological changes, deformities and wounds in human body through micro-trauma or micro-approach, in order to achieve the goal of treatment, its surgical effect is equivalent to the traditional open surgery, while avoiding the morbidity of conventional surgical wounds. In addition, it also has the advantages of less trauma, less blood loss during operation, less psychological burden and quick recovery on patients, and these minimally invasive techniques provide unique value for the examination and treatment of gastric cancer patients. Surgical minimally invasive surgical techniques have developed rapidly and offer numerous options for the treatment of early gastric cancer (EGC): endoscopic mucosal resection (EMR), underwater EMR (UEMR), endoscopic submucosal dissection (ESD), endoscopic full-thickness resection (EFTR), endoscopic submucosal excavation (ESE), submucosal tunnel endoscopic resection), laparoscopic and endoscopic cooperative surgery (LECS); Among them, EMR, EFTR and LECS technologies have a wide range of applications and different modifications have been derived from their respective surgical operations, such as band-assisted EMR (BA-EMR), conventional EMR (CEMR), over-the-scope clip-assisted EFTR, no-touch EFTR, the inverted LECS, closed LECS, and so on. These new and improved minimally invasive surgeries are more precise, specific and effective in treating different types of EGC.

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Comparison of endoscopic full-thickness resection and cap-assisted endoscopic full-thickness resection in the treatment of small (≤1.5 cm) gastric GI stromal tumors

Cited by 15 publications

References 43 publications

Endoscopic full‐thickness resection, indication, methods and perspectives

Endoscopic full‐thickness resection, indication, methods and perspectives

Endoscopic Full Thickness Resection: A Systematic Review

Present situation of minimally invasive surgical treatment for early gastric cancer

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