Abstract
Background
Exposed endoscopic full-thickness resection (Eo-EFTR) is emerging as a promising minimally
invasive alternative to surgery for the treatment of deep gastric submucosal tumors
(G-SMTs). However, literature concerning this subject is heterogeneous and data mostly
come from relatively small retrospective studies.
Aims
We aimed to perform a pooled analysis of published data with regard to gastric Eo-EFTR,
providing a pooled estimate of technical and clinical outcomes.
Methods
The protocol was registered in PROSPERO. MEDLINE and EMBASE databases were searched
for studies published from 1998 to 2020. The primary outcomes were complete resection
and surgical conversion rates. The secondary outcomes were overall and selected major
adverse events rates. The Forest plots on primary and secondary endpoints were produced
based on fixed and random effect models.
Results
Nineteen studies including 952 Eo-EFTR-treated G-SMTs were included. The pooled estimate
of the complete resection rate and surgical conversion rates was 99.3% and 0.09%,
respectively. The pooled estimate of overall major adverse events, delayed bleeding,
delayed perforation and peritonitis, abdominal abscess and/or abdominal infection
was 0.29%, 0.14%, 0.14%, and 0.12%, respectively.
Conclusion
Gastric Eo-EFTR has a high rate of complete resection with a low surgical conversion
rate. It appears to be relatively safe and might represent a non-inferior minimally
invasive alternative to surgery in selected cases.
Keywords
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Article info
Publication history
Published online: October 12, 2021
Accepted:
September 14,
2021
Received in revised form:
September 14,
2021
Received:
May 4,
2021
Identification
Copyright
© 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
