Greater efficiency of the double-bending method compared with conventional endoscopic submucosal dissection for the treatment of submucosal tumors of the gastric fundus

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BACKGROUND AND AIM: In clinical practice, endoscopic resection of submucosal tumors (SMTs) in the gastric fundus is extremely difficult. The aim of our study was to compare the efficiency and safety of the double-bending method (DBM) and conventional endoscopic submucosal dissection (ESD) for the treatment of SMTs in the gastric fundus. METHODS: The clinical data of 190 patients who underwent resection of SMTs in the gastric fundus were retrospectively analyzed. RESULTS: In all, 190 patients with an average age of 53 years were included in this study: 100 patients in the DBM-ESD group and 90 patients in the ESD group. The average operation time was 54.2 min in the DBM-ESD group and 101.6 min in the ESD group (P < 0.001), which indicates that the resection speed was significantly faster in the DBM-ESD group. Subgroup analysis revealed that the larger the tumor volume was, the greater the difference in operation time between the two groups. No significant difference was observed in intraoperative or postoperative complications. CONCLUSIONS: DBM-ESD can be safely and effectively performed to resect SMTs in the gastric fundus and is especially suitable for patients with very large tumor diameters.

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