Correlation of preoperative CT features with intra- and postoperative parameters of endoscopic resection in patients with gastric submucosal tumor (1~3 cm).

Yuxiang Chen, Mo Chen, Zhu Wang, Junchao Wu, Jinlin Yang, Li Yang, Kai Deng

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Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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Yuxiang ChenDepartment of Gastroenterology & Hepatology, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, 610041, Sichuan, China.

Mo ChenDepartment of Gerontology, Tibetan Chengdu Branch Hospital of West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.

Zhu WangDepartment of Gastroenterology & Hepatology, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, 610041, Sichuan, China.

Junchao WuDepartment of Gastroenterology & Hepatology, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, 610041, Sichuan, China.

Jinlin YangDepartment of Gastroenterology & Hepatology, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, 610041, Sichuan, China.

Li YangDepartment of Gastroenterology & Hepatology, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, 610041, Sichuan, China.

Kai DengDepartment of Gastroenterology & Hepatology, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, 610041, Sichuan, China. dengkai@wchscu.cn.ORCID 0000-0002-0096-5211

Funding

Autonomous Region Science and Technology Plan Joint Funding Project XZ202301ZY0050GChengdu Medical Research Program No.2022359National Natural Science Foundation of China No.82470536Sichuan Science and Technology Program 2022YFH0003Sichuan Science and Technology Program 22ZDYF1618Teaching Fund of West china School of Medicine GSSCU2023088Teaching Fund of West china School of Medicine HXBK-B2023052the major technology application and demonstration project, Chengdu Science and Technology Bureau 2021-YF09-00050-SNthe National Key Research and Development Program of china 2022YFC3602101the National Key Research and Development Program of china 2022YFC3602105

6 · The paper itself

Abstract

objectivesEndoscopic resection of gastric submucosal tumors (SMTs) possesses minimal trauma, expedited recovery, and reduced costs. Nonetheless, intraoperative challenges, including imprecise surgical risk assessment, prevail. Hence, we investigated the correlation between preoperative CT observation features and perioperative parameters for predicting outcomes in SMT patients.

methodsSubjects diagnosed with SMT and undergoing endoscopic surgery conducted at West China Hospital's Endoscopy Center from September 2019 to October 2023 were retrospectively selected. Endoscopic ultrasonography (EUS) and computer tomography (CT) were utilized for evaluating SMT. The study assessed the correlation between preoperative CT findings and perioperative parameters.

resultsIncreased lesion size on contrast-enhanced CT correlates with increased operative duration, hospital stay, postoperative antibiotic use. Of utmost significance, we observed a significantly higher intraoperative perforation rate for patients with tumor outgrowth compared to those with lesion involvement of the lumen (96.88% vs 29.11%, P < 0.001). These patients also demonstrated an increased risk of postoperative blood stream infections (P = 0.012), necessitating higher antibiotic grade (P = 0.048), along with prolonged gastrostomy tube retention (P = 0.001) and hospitalization (P = 0.018). In addition, CT provides a more accurate and comprehensive assessment of tumor size (P = 0.037) and growth pattern (P = 0.026) than EUS.

conclusionCT assessment of tumor size closer to reality than EUS. Importantly, these features can assist in pinpointing lesions with elevated surgical complexity and high risk of complications, leading to improved preoperative preparation, thereby increasing anticipation of surgical risks and reducing incidence of complications.

Indexed as

Endoscopic Mucosal ResectionStomach NeoplasmsTomography, X-Ray ComputedAdultAgedEndosonographyFemaleGastric MucosaGastroscopyHumansLength of StayMaleMiddle AgedOperative TimePostoperative ComplicationsPreoperative CareCT featuresPerioperative indicatorsSubmucosal tumorsUltrasound endoscopy

Identifiers

PMID39528660

DOI10.1007/s00464-024-11349-x

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