Endoscopic full-thickness resection for treating small tumors originating from the muscularis propria in the gastric fundus: An improvement in technique over 15 years

Table 1 Patient characteristics

		L-EFTR	S-EFTR	E-EFTR	P value
Female, n (%)	27 (75)	8 (29.6)	8 (29.6)	11 (40.7)	0.554
Age (yr)	55.8 ± 10.20	57.7 ± 8.53	5.35 ± 8.91	57.2 ± 12.83	0.535
Tumor size (mm)	9.0 ± 3.98	6.5 ± 1.96	12.6 ± 4.42	9.6 ± 3.45	0.505

L-EFTR: Ligation-assisted endoscopic full-thickness resection; S-EFTR: Snare-assisted endoscopic full-thickness resection; E-EFTR: Endoscopic submucosal dissection-assisted endoscopic full-thickness resection.

Table 2 Operation time, cost, and en-bloc resection and complication rates

	L-EFTR	S-EFTR	E-EFTR	P value
Total operation duration (min)	27.2 ± 26.28	14.0 ± 8.19	33.0 ± 21.99	0.148
Operation duration of tumor resection (min)	18.4 ± 26.31	4.7 ± 3.39	23.6 ± 13.74	0.085
Operation duration of defect closure (min)	8.8 ± 4.39	9.3 ± 5.07	9.4 ± 9.10	0.965
Total procedure cost (CNY)	5970.7 ± 3465.27	5852.0 ± 6438.25	15837.5 ± 7212.96	< 0.001
Cost of tumor resection (CNY)	3952.2 ± 1866.49	525.0 ± 0	5253.5 ± 2200.48	< 0.001
Cost of defect closure (CNY)	2018.8 ± 3232.47	5237.0 ± 6438.25	10584.0 ± 5857.06	0.001
En-bloc resection rate, %	100	100	100
Complication rate, %	0	0	0

L-EFTR: Ligation-assisted endoscopic full-thickness resection; S-EFTR: Snare-assisted endoscopic full-thickness resection; E-EFTR: Endoscopic submucosal dissection-assisted endoscopic full-thickness resection.

Table 3 Cost comparison for the whole procedure

	Total procedure cost
	β	Standard error	Standardization coefficient	95%CI	P value
L-EFTR vs S-EFTR	7220.69	2138.94	0.766	(2743.83, 11697.54)	0.003
L-EFTR vs E-EFTR	-8556.61	2124.56	-0.593	(-12962.67, -4150.55)	0.001
S-EFTR vs E-EFTR	-14876.08	2282.57	-0.896	(-19714.91, -10037.26)	< 0.001

Adjusted for sex, age, and tumor size as confirmed using endoscopic ultrasound. L-EFTR: Ligation-assisted endoscopic full-thickness resection; S-EFTR: Snare-assisted endoscopic full-thickness resection; E-EFTR: Endoscopic submucosal dissection-assisted endoscopic full-thickness resection; CI: Confidence interval.

Table 4 Cost comparison for tumor resection

	Cost of tumor resection
	β	Standard error	Standardization coefficient	95%CI	P value
L-EFTR vs S-EFTR	3653.83	913.13	0.809	(1742.63, 5565.02)	0.001
L-EFTR vs E-EFTR	-1277.22	905.56	-0.310	(-3155.24, 600.79)	0.172
S-EFTR vs E-EFTR	-4777.27	820.07	-0.835	(-6515.75, -3038.80)	< 0.001

Adjusted for sex, age, and tumor size as confirmed using endoscopic ultrasound. L-EFTR: Ligation-assisted endoscopic full-thickness resection; S-EFTR: Snare-assisted endoscopic full-thickness resection; E-EFTR: Endoscopic submucosal dissection-assisted endoscopic full-thickness resection; CI: Confidence interval.

Table 5 Cost comparison for defect closure

	Cost of defect closure
	β	Standard error	Standardization coefficient	95%CI	P value
L-EFTR vs S-EFTR	3567.39	2099.27	0.364	(-826.43, 7961.20)	0.106
L-EFTR vs E-EFTR	-7278.81	1843.43	-0.591	(-11101.85, -3455.76)	0.001
S-EFTR vs E-EFTR	-10098.81	1835.18	-0.785	(-13989.22, -6208.40)	< 0.001

Adjusted for sex, age, and tumor size as confirmed using endoscopic ultrasound. L-EFTR: Ligation-assisted endoscopic full-thickness resection; S-EFTR: Snare-assisted endoscopic full-thickness resection; E-EFTR: Endoscopic submucosal dissection-assisted endoscopic full-thickness resection; CI: Confidence interval.