The use of band-assisted endoscopic mucosal resection (BA-EMR) was found to be safe and effective for the removal of small gastrointestinal stromal tumors (GISTs), Study results were published in Surgical Endoscopy.

The study found that for submucosal tumors (SMTs) smaller than 1.2 cm in the gastric fundus, BA-EMR may reduce complications, simplify the treatment procedure, and decrease the operation time compared to standard endoscopic dissection (ESD).

“We demonstrated that BA-EMR is a safe and effective method for small SMTs in the gastric fundus, although it is only suitable for SMTs <1.2 cm,” the authors said.


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The patients receiving BA-EMR had lower incidences of intraoperative bleeding (0 vs 3; P =.010), perforation (23.8% vs 50%; P =.039), and proportion of punctures (P =.019) than those in the ESD group.

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Shorter operation time (19.09 minutes vs 47.55 minutes; P =.001) and hospital stay (5.05 days vs 9.65 days; P =.015) and lower incidences of postoperative fever (2 vs 5; P =.019) and abdominal pain (1 vs 4; P =.017) were all observed in the BA-EMR group compared to the ESD group. No patients in either group had a recurrence or residual lesions observed on endoscopy or endoscopic ultrasound at the 6-month follow-up.

The mean tumor size in the BA-EMR group was 0.94±0.16 cm compared to 1.30±0.04 cm in the ESD group. Eight SMTs measuring at least 1.2 cm were removed during surgery. Of these, only 2 were successfully removed using BA-EMR, while the other 6 were converted to ESD.

“The reason for the failure might be related to the diameter of the transparent cap and the hard texture of the stromal tumor. Therefore, for SMTs ≥1.2 cm, BA-EMR is not an optimal choice of treatment,” the authors said.

Sixty-two patients with GISTs were recruited for the study; they had an average age of 56.92 years and tumors less than 1.5 cm in size. All patients underwent BA-EMR, but those whose lesion was not completely ligated by the rubber band or whose rubber band fell off after ligation then underwent ESD.

Reference

Pan W, Shi D. Band-assisted endoscopic mucosal resection for small (≤ 1.5 cm) submucosal tumors originating from the muscularis propria in the gastric fundus: a prospective study. Surg Endosc. Published online October 13, 2022. doi:10.1007/s00464-022-09688-8