Journal of Shandong University (Health Sciences) ›› 2021, Vol. 59 ›› Issue (3): 74-80.doi: 10.6040/j.issn.1671-7554.0.2020.1446

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Evaluation of the efficacy and complications of endoscopic treatment of 240 cases of upper gastrointestinal submucosal tumors

LUO Yingshu1, LI Bin2, XU Changqin2, JIANG Junmei2, XU Hongwei1,2   

  1. 1. Department of Gastroenterology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong, China;
    2. Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China
  • Published:2021-04-06

Abstract: Objective To explore the clinical characteristics of upper gastrointestinal submucosal tumors(SMT)and clinical factors affecting postoperative complications and hospitalization costs of SMT patients. Methods The clinical data of 240 SMT patients treated in Shandong Provincial Hospital during Jan. 2012 and Jun. 2019 were collected, and the clinical characteristics, pathological types, treatment modalities and therapeutic effects were analyzed. Results The patients included 101 male(42.1%)and 139 female(57.9%), mean age 54.19 years, and mean size of SMT 1.12 cm. The tumors were located in the esophagus in 57 cases(23.8%), in the gastroesophageal junction in 17 cases(7.1%), in the stomach in 163 cases(67.9%), and in the duodenum in 3 cases(1.3%). Endoscopic submucosal dissection(ESD)was performed in 69 patients(28.8%), endoscopic submucosal excavation(ESE)in 117 patients(48.8%), endoscopic full-thickness resection(EFR)in 28 patients(11.7%), and submucosal tunneling endoscopic resection(STER)in 26 patients(10.7%). The main pathological types were leiomyoma(117, 49.2%)and stromal tumor(78, 32.8%). Altogether 237 patients(98.8%)were successfully treated, with 90.4%(217/240)en bloc resection rate. The mean operation time was 58.37 minutes, hospital stay 10.07 days, and hospitalization costs 35 830.3 yuan. Complications were observed in 17 patients(7.1%), 10(4.2%)of whom relieved after conservative treatment and 7(2.9%)received active interventions such as endoscopic hemostasis, gastrointestinal decompression and puncture drainage. No death or long-term complications occurred. Operation time ≥55 min and SMT≥2 cm were the risk factors of postoperative complications; meanwhile, operation time ≥55 min, SMT≥2 cm, failure of en bloc resection and use of OTSC increased hospitalization costs. Conclusion Endoscopic resection is a safe and effective treatment modality of SMT. Early detection, early treatment and short operation time are effective ways to reduce the incidence of postoperative complications and hospitalization costs.

Key words: Submucosal tumors, Endoscope, Clinical characteristics, Efficacy, Complications

CLC Number: 

  • R735
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