To investigate the efficacy and safety of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) in treatment of upper gastrointestinal submucosal tumors (SMT), and the high risk factors of intraoperative perforation, 201 patients with upper gastrointestinal submucosal tumors treated in Department of Gastroenterology of the first Affiliated Hospital of Chongqing Medical University from June 2018 to June 2023 were selected and divided into EMR group and ESD group according to the mode of operation. The success rate, hospitalization cost, hospitalization time, postoperative fasting time, intraoperative and postoperative complications and postoperative follow-up were compared. According to the occurrence of intraoperative perforation, patients were divided into two groups: non-perforation group and non-perforation group. The clinical data of age, sex, smoking history, drinking history, diabetes, hypertension, tumor size, tumor location and origin were collected. Multivariate Logistic regression model was used to analyze the high risk factors of intraoperative perforation. There was no significant difference in complete resection rate, postoperative residual and recurrence rate, intraoperative bleeding rate and postoperative complication rate between EMR group and ESD group, but the fasting time and average hospital stay in ESD group were longer than those in EMR group, and the intraoperative perforation rate in EMR group was significantly lower than that in ESD group. The age in the perforation group was significantly older than that in non-perforation group, and the proportion of diabetes located in the fundus of the stomach, originating from the lamina propria and ESD treatment in the perforation group, was significantly higher than that in non-perforation group. The results of binary Logistic regression analysis showed that diabetes history, endoscopic treatment (ESD) and lesion origin (lamina propria) were independent risk factors for intraoperative perforation. Therefore,it is effective to treat SMT, EMR and ESD of upper digestive tract, but EMR has fewer complications, shorter hospitalization time and lower hospitalization cost than ESD. The history of diabetes, endoscopic treatment (ESD) and the origin of the lesion (lamina propria) are important factors affecting intraoperative perforation.

Liu Yinghao, Qiao Min. Analysis of the Efficacy and Safety of Different Endoscopic Surgery in Treatment of Upper Gastrointestinal Submucosal Tumors. International Journal of Frontiers in Medicine (2024), Vol. 6, Issue 5: 115-120. https://doi.org/10.25236/IJFM.2024.060516.

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