A35 ENDOSCOPIC SUBMUCOSAL DISSECTION (ESD) OUTCOMES IN GASTROINTESTINAL SUBMUCOSAL TUMORS (SMT): A RETROSPECTIVE STUDY
Notice bibliographique
Résumé
Abstract Background Gastrointestinal submucosal tumors (SMTs) range from benign entities to malignant tumors that require surveillence or resection. The role of ESD in management of SMTs remains unclear. Aims We aim to evaluate the clinical and technical outcomes of ESD in the management of SMTs. Methods This study included patients with SMTs who underwent ESD at the Kingston Health Sciences Center (KHSC) between May 2017 to September 2024. Data was collected on patient demographics and tumor characteristics including size, pathology, differentiation, depth, and lymphovascular invasion (LVI). Technical outcomes were analyzed with respect to procedure time (min), technical efficiency (min/cm2), en-bloc and R0 resection rates. En-bloc resection was defined as resection of the lesion piecemeal and R0 indicated negative margins on microscopic examination. We also reported clinical outcomes including length of stay, perioperative adverse events (e.g. bleeding or perforation), strictures, and tumor recurrence rates at the time of follow-up. Descriptive analysis was used to summarize the data. Results This case series included 22 patients (7 males, 15 females) with SMTs (6 esophageal, 16 gastric). 40.1% of patients (9/22) had endoscopic biopsy prior to ESD. The median specimen area was 3.8 cm2 (min-max range 0.38-18.2 cm2). Procedure times ranged between 5-138 mins with a mean time of 49.6 mins (SD= 33.1 mins) and mean efficiency of 13.7 min/cm2. 100% of patients had en-bloc resections and 86.3% (19/22) had R0 resections. There were no perioperative adverse events and most patients (21/22) were discharged the same day with the exception of one patient who stayed for 6 days postoperatively for (chronic) pain management. The pathology of the six esophageal tumors showed 3 leiomyomas, 2 Granular Cell Tumors (GCT), and 1 lipoma. Of the sixteen gastric lesions, 6 were Gastrointestinal Stromal Tumors (GIST), 6 were neuroendocrine tumors (NET), 1 leiomyoma, 1 lipoma, 1 inflammatory fibroid polyp, and 1 heterotopic pancreatic tissue. In both GIST and NET tumors, 5/6 lesions were Grade 1 (well-differentiated) and 1/6 was Grade 2 (moderately differentiated). The depth of the lesions was into the submucosa and there was no lymphovascular invasion (LVI). With regards to the esophageal tumors that required endoscopic follow-up (n= 4), the mean follow-up time was 8.5 months and there was no tumor recurrence. Of the gastric lesions that required endoscopic follow-up (n= 14), the mean follow-up time was 26.2 months and there was no tumor recurrence. There were no strictures observed on endoscopic follow-up for any of the lesions. Conclusions ESD for SMTs is a safe procedure with high en-bloc and R0 resection rates, along with low recurrence rates on follow-up. Larger scale studies are needed to further explore the efficacy and safety of ESD in the management of SMTs. Funding Agencies None
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».