Work

Retrospective comparison of precutting endoscopic band ligation and endoscopic submucosal dissection for small gastric muscularis propria tumors

Year: 2026

Type: article

Abstract: BACKGROUND The clinical management of small gastric submucosal tumors originating from the muscularis propria layer is a non-negligible challenge. We have proposed a safe and simple method called precutting endoscopic band ligation (EBL). AIM To assess the long-term viability of endoscopic submucosal dissection (ESD) and precutting EBL and clarify precutting EBL’s safety and efficacy. METHODS In this retrospective study, 94 patients with small gastric muscularis propria tumors underwent ESD or precutting EBL at a tertiary hospital. Patient demographics, tumor characteristics, procedure details, adverse events (AEs), and long-term follow-up data were collected. The number of participants was determined to provide sufficient statistical power for the analyses. Continuous variables were analyzed using t -tests or Mann-Whitney U tests, and categorical variables with χ 2 or Fisher’s exact tests. Multivariate linear regression with inverse probability of treatment weighting balanced baseline differences between groups. RESULTS We reviewed 94 patients with gastric submucosal tumors originating from the muscularis propria layer (< 20 mm), including 48 treated by ESD and 46 by precutting EBL. No local recurrences were detected in either group during follow-up, and the median follow-up period was 48.60 months (interquartile range: 48.00-60.00) in the ESD group and 52.00 months (interquartile range: 36.00-84.00) in the precutting EBL group. However, precutting EBL was significantly superior in terms of operative time (46 minutes vs 17 minutes, P < 0.001) and the AE rate (11.47% vs 0%, P = 0.024). CONCLUSION Precutting EBL had a shorter operative time than ESD and was associated with no AEs. Future randomized controlled studies are required to confirm the feasibility of this approach.

Source: World Journal of Gastrointestinal Endoscopy

DOI: 10.4253/wjge.v18.i2.114400