title: Comparison of endoscopic submucosal dissection and surgical resection for treating gastric subepithelial tumours.
abstract: OBJECTIVE
  For subepithelial tumours (SETs) of the stomach, surgical resection is the gold standard treatment. With the recent advent of endoscopic resection techniques and devices, endoscopic submucosal dissection (ESD) has been considered as an alternative treatment for SETs. The aim of our study was to evaluate the clinical outcomes of ESD for treating gastric SETs compared with surgical resection.
  
  
  METHODS
  Between January 2006 and September 2014, 55 patients with gastric SETs (13 gastrointestinal stromal tumours (GISTs), 27 leiomyomas, and 15 others) were treated by ESD and 27 patients (19 GISTs, two leiomyomas, and six others) underwent surgical resection. We retrospectively reviewed the therapeutic outcomes, procedure-related complications, post-procedure hospital stays, and medical costs of the two groups.
  
  
  RESULTS
  The complete resection rate of the ESD group was lower than that of the surgery group (81.8% vs. 100%, p = 0.026). Although the incidence of complications that occurred with ESD was higher than that associated with surgical resection, there were no significant between-group differences (12.5% vs. 3.7%, p = 0.261), and all complicated cases were successfully treated without mortality. The ESD group had significantly shorter post-procedural hospital stays (median five days vs. eight days, p = 0.034) and lower medical costs (median $2374 vs. $4954, p <0.001) than the surgery group. There were no recurrences in either group during the follow-up period.
  
  
  CONCLUSIONS
  ESD is an efficient treatment tool for gastric SETs in selected patients. Additionally, ESD has the advantages of shorter hospital stays and lower medical costs compared with surgery.
authors.affiliation: a Department of Internal Medicine , University of Hallym College of Medicine, Hallym University Sacred Heart Hospital , Anyang , Republic of Korea ;
authors.forename: Jae Seung
authors.initials: JS
authors.lastname: Soh
authors.affiliation: a Department of Internal Medicine , University of Hallym College of Medicine, Hallym University Sacred Heart Hospital , Anyang , Republic of Korea ;
authors.forename: Ja Kyung
authors.initials: JK
authors.lastname: Kim
authors.affiliation: a Department of Internal Medicine , University of Hallym College of Medicine, Hallym University Sacred Heart Hospital , Anyang , Republic of Korea ;
authors.forename: Hyun
authors.initials: H
authors.lastname: Lim
authors.affiliation: a Department of Internal Medicine , University of Hallym College of Medicine, Hallym University Sacred Heart Hospital , Anyang , Republic of Korea ;
authors.forename: Ho Suk
authors.initials: HS
authors.lastname: Kang
authors.affiliation: a Department of Internal Medicine , University of Hallym College of Medicine, Hallym University Sacred Heart Hospital , Anyang , Republic of Korea ;
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Park
authors.affiliation: a Department of Internal Medicine , University of Hallym College of Medicine, Hallym University Sacred Heart Hospital , Anyang , Republic of Korea ;
authors.forename: Sung Eun
authors.initials: SE
authors.lastname: Kim
authors.affiliation: a Department of Internal Medicine , University of Hallym College of Medicine, Hallym University Sacred Heart Hospital , Anyang , Republic of Korea ;
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Moon
authors.affiliation: a Department of Internal Medicine , University of Hallym College of Medicine, Hallym University Sacred Heart Hospital , Anyang , Republic of Korea ;
authors.forename: Jong Hyeok
authors.initials: JH
authors.lastname: Kim
authors.affiliation: a Department of Internal Medicine , University of Hallym College of Medicine, Hallym University Sacred Heart Hospital , Anyang , Republic of Korea ;
authors.forename: Choong Kee
authors.initials: CK
authors.lastname: Park
authors.affiliation: b Department of Surgery , University of Hallym College of Medicine, Hallym University Sacred Heart Hospital , Anyang , Republic of Korea ;
authors.forename: Ji Woong
authors.initials: JW
authors.lastname: Cho
authors.affiliation: b Department of Surgery , University of Hallym College of Medicine, Hallym University Sacred Heart Hospital , Anyang , Republic of Korea ;
authors.forename: Man Sup
authors.initials: MS
authors.lastname: Lim
authors.affiliation: c Department of Internal Medicine , Gachon University Gil Medical Center , Incheon , Republic of Korea.
authors.forename: Kyoung Oh
authors.initials: KO
authors.lastname: Kim
mesh_terms: D000328:Adult; D004210:Dissection / Q000379:methods*; D019160:Endosonography; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis / Q000601:surgery*; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Endoscopic submucosal dissection; stomach; subepithelial tumour; surgical resection