Effectiveness of snare traction facilitated endoscopic resection for gastric submucosal tumors≥2 cm: a propensity score-matched study

Aims Endoscopic resection (ER) have been used to resect gastric submucosal tumors (SMTs). However, ER was a technically demanding but effective treatment for gastric SMTs, especially for tumor size≥2cm, hinder its wider application. Traction-assisted ER was a method to provide better outcomes than conventional endoscopic procedure in treating gastric SMTs. Our team explored a method of tumor traction using snare. And the aim of this study was to assess the efficacy of snare traction technique in assisting the ER procedure in gastric SMTs≥2cm.

Methods Between Janunary 2015 and December 2022, we retrospectively reviewed data from patients with gastric SMTs≥2cm were treated by ER at the first affiliated hospital of Zhengzhou university. Then, propensity score matching (1:3) between snare traction-assisted and conventional ER procedure were used to overcome selection bias. The success rate, en bloc resection rate, dissection time, dissection speed and perioperative complications were compared.

Results A total of 314 patients were included in this study. After propensity score matching (PSM), 34 patients were enrolled in the snare traction-assisted endoscopic resection group (STAER) and 102 patients were enrolled in the conventional endoscopic resection group (CER). STAER group had a higher dissection speed (6.60 vs. 5.20 mm²/min; P=0.030) and shorter dissection time (76.00 vs 76.50 min, P=0.003). There were no significant differences in technique success rate, en bloc resection rate, and perioperative complications between the two groups. In subgroup analysis, the dissection speed of STAER was significantly higher than that of CER when the lesions length was 2-5 cm, underwent endoscopic full-thickness resection, and located in gastric antrum.

Conclusions STAER demonstrated a higher efficiency for gastric SMTs≥2cm, without increasing the perioperative complications. Further prospective studies are needed to assess the efficiency and safety of STAER method.

Publication History

Article published online:
27 March 2025