Retrospective comparison of precutting endoscopic band ligation and endoscopic submucosal dissection for small gastric muscularis propria tumors

doi:10.4253/wjge.v18.i2.114400

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World Journal of Gastrointestinal Endoscopy

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1948-5190

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastrointest Endosc. Feb 16, 2026; 18(2): 114400
Published online Feb 16, 2026. doi: 10.4253/wjge.v18.i2.114400

Retrospective comparison of precutting endoscopic band ligation and endoscopic submucosal dissection for small gastric muscularis propria tumors

Yu Ou, Jue Wang, Ming-Feng Liu, Rui Yuan, Jiang Min, Shan Li, Liang Deng

Yu Ou, Jue Wang, Ming-Feng Liu, Rui Yuan, Shan Li, Liang Deng, Department of Gastroenterology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

Jiang Min, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

Co-first authors: Yu Ou and Jue Wang.

Co-corresponding authors: Shan Li and Liang Deng.

Author contributions: Ou Y, Wang J, Li S, and Deng L designed and conducted the study and wrote the paper; Ou Y and Wang J contributed equally to this work and were responsible for the study design, data acquisition, data analysis, and manuscript drafting; they contributed equally to this article, and they are the co-first authors of this manuscript; Liu MF, Yuan R, Min J, and Li S provided clinical advice; Li S and Deng L were involved in study design, interpretation of the results, and critical revision of the manuscript, and Li S and Deng L contributed equally to this article and are the co-corresponding authors of this manuscript; all authors thoroughly reviewed and endorsed the final manuscript.

Supported by the Joint Project Foundation of Chongqing Health Commission and Chongqing Scientific and Technological Commission, No. 2021MSXM103; Chongqing Science and Technology Commission Foundation, No. cstc2020jcyj-msxmX0045; and the Natural Science Foundation of Chongqing, No. cstc2020jcyj-msxmX0288.

Institutional review board statement: This study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Chongqing Medical University, approval No. K2024-142-01.

Informed consent statement: Owing to the retrospective design of this study, the need for informed consent was exempted by the institutional review board.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: The datasets generated or analyzed during the current study are fully contained within this article. Additional details can be obtained from the corresponding author upon reasonable request.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Liang Deng, PhD, Associate Professor, Chief Physician, Director, Department of Gastroenterology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, China. dengliang@hospital.cqmu.edu.cn

Received: September 19, 2025
Revised: November 9, 2025
Accepted: January 4, 2026
Published online: February 16, 2026
Processing time: 138 Days and 20.2 Hours

Abstract

BACKGROUND

The clinical management of small gastric submucosal tumors originating from the muscularis propria layer is a non-negligible challenge. We have proposed a safe and simple method called precutting endoscopic band ligation (EBL).

AIM

To assess the long-term viability of endoscopic submucosal dissection (ESD) and precutting EBL and clarify precutting EBL’s safety and efficacy.

METHODS

In this retrospective study, 94 patients with small gastric muscularis propria tumors underwent ESD or precutting EBL at a tertiary hospital. Patient demographics, tumor characteristics, procedure details, adverse events (AEs), and long-term follow-up data were collected. The number of participants was determined to provide sufficient statistical power for the analyses. Continuous variables were analyzed using t-tests or Mann-Whitney U tests, and categorical variables with χ² or Fisher’s exact tests. Multivariate linear regression with inverse probability of treatment weighting balanced baseline differences between groups.

RESULTS

We reviewed 94 patients with gastric submucosal tumors originating from the muscularis propria layer (< 20 mm), including 48 treated by ESD and 46 by precutting EBL. No local recurrences were detected in either group during follow-up, and the median follow-up period was 48.60 months (interquartile range: 48.00-60.00) in the ESD group and 52.00 months (interquartile range: 36.00-84.00) in the precutting EBL group. However, precutting EBL was significantly superior in terms of operative time (46 minutes vs 17 minutes, P < 0.001) and the AE rate (11.47% vs 0%, P = 0.024).

CONCLUSION

Precutting EBL had a shorter operative time than ESD and was associated with no AEs. Future randomized controlled studies are required to confirm the feasibility of this approach.

Keywords: Endoscopic submucosal dissection; Gastrointestinal stromal tumors; Therapeutics; Muscularis propria; Precutting endoscopic band ligation

Core Tip: This article compared endoscopic submucosal dissection and precutting endoscopic band ligation (EBL) for gastric submucosal tumors < 20 mm originating from the muscularis propria. Both techniques achieved excellent long-term tumor control without recurrence, but precutting EBL demonstrated significant advantages, including a shorter operative time and fewer adverse events. These findings suggest that precutting EBL is a safer, simpler, and more efficient alternative to endoscopic submucosal dissection, warranting further validation in prospective randomized controlled trials.