A multicentre study has revealed promising findings related to the treatment of gastric muscularis propria lesions, focusing on two distinct endoscopic procedures: endoscopic snare resection with elastic band (ESR-EB) and endoscopic snare resection with transparent cap (ESR-C). This research, which is the first of its kind to compare these two techniques, aims to address gaps in existing knowledge about the safety and effectiveness of endoscopic treatment options for small gastric lesions, particularly those under 10 mm.
Conducted from May to November 2023 across three hospitals located in Shenzhen, Shantou, and Zhongshan, China, the study included 64 patients diagnosed with gastric muscularis propria lesions. The study enrolled patients with lesions less than 10 mm, aiming to offer precise, less invasive treatment without the drawbacks of prolonged follow-up and potential complications associated with other procedures.
The results demonstrated significant differences between ESR-EB and ESR-C. While both methods achieved 100% complete resection with no recurrence or metastasis during follow-up, ESR-EB had lower operation times and complication rates, indicating its potential superiority as the preferred endoscopic procedure among clinicians.
The operation time for ESR-C was observed to be significantly greater than for ESR-EB, averaging 41.31 minutes compared to 26.26 minutes respectively. Complications also varied substantially, with ESR-C presenting a higher complication rate—72.41% of patients experienced perforations compared to just 20% with ESR-EB. Such findings not only validate previous insights about the relative safety of these endoscopic techniques but add considerable evidence to support the continued exploration of methods aimed at improving patient outcomes.
This multicentre prospective cohort study is notable for its careful design wherein the surgical risks were monitored closely, and surgeries were performed by experienced endoscopists. The participating institutions upheld rigorous ethical standards, ensuring informed consent was obtained from all patients. These procedural details set the foundation for the outcomes reported and allow for confidence in the observed findings.
The decision to utilize ESR-EB or ESR-C often relies on the expertise of the operator, as well as specific tumor characteristics including size, growth pattern, and overall positioning. Research has shown the increasing need for effective endoscopic techniques especially as the incidence of gastric muscularis propria lesions continues to grow.
Through this study, researchers aim to bolster clinical practice guidelines around gastric muscularis propria lesions by providing reliable data on these two endoscopic resection methods. With increasing numbers of patients facing smaller gastric lesions, establishing the most efficient technique for treatment is of the utmost importance. The pursuit of optimal methods for treatment—specifically for lesions less than 10 mm—can lead to improved patient care protocols and more favorable outcomes.
Postoperative outcomes from this study indicate both ESR-EB and ESR-C yield successful results; nonetheless, the clear differences noted such as speed of procedure and complication rates present strong arguments favoring ESR-EB for clinical adoption. These findings may very well influence how endoscopists select their approach moving forward, establishing ESR-EB as potentially the go-to method for treating gastric muscularis propria lesions.
This research highlights the importance of evidence-based decision-making within medical practices—setting the stage for future studies and perhaps lowering adverse event rates associated with endoscopic procedures.