Comparison of endoscopic resection, laparoscopic resection, and laparoscopic endoscopic cooperative surgery in esophageal or gastric subepithelial lesions in a Thai medical school.

IF 0.9 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL
Asian Biomedicine Pub Date : 2025-09-08 eCollection Date: 2025-08-01 DOI:10.2478/abm-2025-0026
Phuphat Vongwattanakit, Voranaddha Vacharathit, Kasaya Tantiphlachiva, Mawin Vongsaisuwon, Chadin Tharavej, Sopark Manasnayakorn, Pornpol Palanusorn
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引用次数: 0

Abstract

Background: Esophageal and gastric subepithelial lesions (SELs) are increasingly identified in routine endoscopic evaluations, necessitating optimal resection strategies. Minimally invasive techniques, including endoscopic resection (ER), laparoscopic resection (LR), and laparoscopic-endoscopic cooperative surgery (LECS), have distinct advantages. The present study compares the outcomes of these techniques.

Objective: To compare the clinical outcomes of ER, LR, and LECS in the management of esophageal or gastric SELs at King Chulalongkorn Memorial Hospital.

Methods: A retrospective review was conducted on patients undergoing ER, LR, or LECS for esophageal and gastric SELs from January 2012 to August 2022. The primary outcome was the complete resection rate. Secondary outcomes included success rates, complications, and length of hospital stay. Statistical significance was set at P < 0.05.

Results: Among 42 patients, 11 (26.2%) underwent ER, 12 (28.6%) underwent LR, and 19 (45.2%) underwent LECS. Complete resection was significantly higher in LR (100%) and LECS (84.2%) than ER (45.5%) (P = 0.033). Delayed bleeding occurred in 18.2% of ER cases (P = 0.052). Hospital stay was shortest in ER (3.9 d) and longest in LR (9.3 d) (P = 0.877).

Conclusion: While all techniques had high success rates, ER had the lowest complete resection rate and the highest bleeding risk. LR ensured complete resection but required longer hospitalization. LECS provided a balance between oncologic efficacy and safety. Surgical planning should be tailored based on tumor characteristics and surgical expertise.

泰国医学院食管或胃上皮下病变的内镜切除、腹腔镜切除和腹腔镜内镜配合手术的比较
背景:食管和胃上皮下病变(SELs)越来越多地在常规内镜评估中被发现,需要最佳的切除策略。微创技术,包括内镜切除(ER)、腹腔镜切除(LR)和腹腔镜-内镜联合手术(LECS),具有明显的优势。本研究比较了这些技术的结果。目的:比较在朱拉隆功国王纪念医院,ER、LR和LECS治疗食管或胃sel的临床结果。方法:回顾性分析2012年1月至2022年8月期间接受ER、LR或LECS治疗食管和胃SELs的患者。主要结果是完全切除率。次要结局包括成功率、并发症和住院时间。差异有统计学意义,P < 0.05。结果:42例患者中,ER 11例(26.2%),LR 12例(28.6%),LECS 19例(45.2%)。完全切除LR(100%)和LECS(84.2%)明显高于ER (45.5%) (P = 0.033)。迟发性出血发生率为18.2% (P = 0.052)。急诊住院时间最短(3.9 d), LR住院时间最长(9.3 d) (P = 0.877)。结论:所有手术成功率均较高,但ER手术全切率最低,出血风险最高。LR确保完全切除,但需要更长的住院时间。LECS提供了肿瘤疗效和安全性之间的平衡。手术计划应根据肿瘤特点和外科专业知识量身定制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Asian Biomedicine
Asian Biomedicine 医学-医学:研究与实验
CiteScore
1.20
自引率
0.00%
发文量
24
审稿时长
6-12 weeks
期刊介绍: Asian Biomedicine: Research, Reviews and News (ISSN 1905-7415 print; 1875-855X online) is published in one volume (of 6 bimonthly issues) a year since 2007. [...]Asian Biomedicine is an international, general medical and biomedical journal that aims to publish original peer-reviewed contributions dealing with various topics in the biomedical and health sciences from basic experimental to clinical aspects. The work and authorship must be strongly affiliated with a country in Asia, or with specific importance and relevance to the Asian region. The Journal will publish reviews, original experimental studies, observational studies, technical and clinical (case) reports, practice guidelines, historical perspectives of Asian biomedicine, clinicopathological conferences, and commentaries Asian biomedicine is intended for a broad and international audience, primarily those in the health professions including researchers, physician practitioners, basic medical scientists, dentists, educators, administrators, those in the assistive professions, such as nurses, and the many types of allied health professionals in research and health care delivery systems including those in training.
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