Authors (including presenting author) :
Sze KK(1), Li KK(1), Ma YK(1)
Affiliation :
(1)Gastroenterology and Hepatology team, Department of Medicine and Geriatrics, Tuen Mun Hospital, NTWC
Introduction :
Gastric subepithelial lesions (SELs) are not uncommon findings in patients received upper endoscopy. Among gastric SELs, small (<20mm) gastrointestinal stromal tumors (GISTs) that without surgical indication require regular surveillance due to their minute but not negligible risk (Fig 1). The burden of regular surveillance using endoscopic ultrasound (EUS) can be a pressure point to healthcare resources due to the growing number of patients and increasing awareness among clinical practitioners. Recently, there is growing evidence that supports the endoscopic full-thickness resection (EFTR) of small SELs including GISTs (Fig 2).
Objectives :
We would like to present the preliminary result of our pilot program using a novel endoscopic device - Full-Thickness Resection Device (FTRD) to resect small suspected GISTs. The objective is to assess the clinical outcomes and safety of FTRD and to estimate the number of surveillance EUS and the associated clinic visits saved.
Methodology :
Patients who had suspected GISTs with size less than 20mm after examination by EUS and agreed for endoscopic resection by FTRD in Tuen Mun Hospital from May 2024 to October 2024 were recruited. Their clinical characteristics and outcomes were retrieved and analyzed. Means and ranges were used for continuous variables while frequencies with percentages were used for categorical data. Outcome measures included technical success rate, complete resection rate, adverse events rate, the number of EUS sessions saved.
Result & Outcome :
Eight patients underwent endoscopic resection of gastric SELs by FTRD during the study period and 62.5% were female (Table 1). Their mean age was 64.4. The average size of the SELs was 7.6mm. Histological assessment revealed 75% of specimens were GIST (Table 2). The technical success rate and the complete resection rate were 100% and 87.5% respectively. There was no immediate and delayed adverse event. There was a net saving of 5.75 EUS sessions per patient or 46 EUS sessions for eight patients after endoscopic resection of suspected GISTs by FTRD.
