Title : Preset pursestring procedure: Innovative auxiliary method of endoscopic full-thickness resection in small gastric stromal tumors
Abstract:
Background and study aims: Endoscopic full-thickness resection (EFR) of gastric stromal tumors carries a high peritonitis risk. Our case report implied the preset pursestring procedure (PPP) could boost EFR speed and safety, but supporting clinical evidence is lacking, prompting this clinical evaluation of PPP in gastric EFR.
Patients and methods: This retrospective cohort study analyzed adults with small gastric stromal tumors who underwent EFR (n = 31) or PPP-assisted EFR (PPP-EFR, n = 28) between August 2022 and August 2023. Tumor characteristics, adverse events, postoperative efficacy, economic outcomes, and follow-up data were compared between groups.
Results: R0 resection rates were comparable (PPP-EFR: 92.8%; EFR: 90.0%). PPP-EFR had shorter closure time (3.5 vs. 19.5 min, P = 0.001). PPP-EFR had lower incidence of postoperative fever (10.7% vs. 32.3%, P = 0.040), computed tomography-confirmed peritonitis (7.1% vs. 29.0%,P = 0.031), and elevated inflammatory markers (P ≤ 0.003), plus shorter fasting time (P = 0.038). Operative time, hospital stay, and cost did not differ; no patients had recurrence or metastasis on follow-up.
Conclusions: PPP optimizes EFR closure, reduces inflammatory and abdominal complications, and improves postoperative recovery for small gastric stromal tumors.
