SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Surgical Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1584205
The Efficacy and Safety of Submucosal Tunnel Endoscopic Resection for the Treatment of Upper Gastrointestinal Submucosal Tumors: A Systematic Review and Meta-analysis
Provisionally accepted
- West China Hospital, Sichuan University, Chengdu, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: The comprehensive systematic review was conducted to assess the efficacy and associated factors of submucosal tunnel endoscopic resection (STER) in the treatment of upper gastrointestinal submucosal tumor. Methods: Databases including PubMed, Web of Science, CNKI, Wang Fang, VIP and Embase were electronically searched for studies on STER for the treatment of upper gastrointestinal submucosal tumors from inception to September 17, 2024. Two authors conducted the literature search independently. A third author resolved any inconsistencies raised between the two. Keywords were used for retrieval, and Boolean operators were used accordingly. Statistical analysis was performed using Stata 16 software. χ2 test was used to analyze the heterogeneity among the studies. The fixed effects model and random effects model were used for meta-analysis. Standardized Mean Difference (SMD), Relative Risk (RR), and 95% CI were used to estimate clinical efficacy/effectiveness. Funnel plot symmetry was used to assess the risk of publication bias between studies. Results: Eight retrospective studies were ultimately incorporated into the meta-analysis. The experimental group was treated with STER. The control groups included patients receiving conventional endoscopic treatments such as ESD, EFTR, ESE, or LECS. The results of this analysis indicated no statistically significant differences between the intervention group and the control group in complete removal rates [RR=0.98 (0.94, 1.03), P>0.01], mean hospital stay [SMD=-0.40 (-0.89, 0.09), P>0.01], mean operation time [SMD=0.08 (-0.40, 0.57), P>0.01], or complication rates [RR=0.91 (0.44, 1.90), P>0.01]. Subgroup analysis identified age and tumor sizes as sources of heterogeneity in complication rates.In patients older than 55 years, STER exhibited a significantly lower risk of complications compared to traditional treatment modalities, with a risk ratio of 0.151 (95% CI: 0.041-0.558; P < 0.05). This indicates that STER may be a particularly beneficial option for this patient demographic. These findings suggest that STER may constitute a more advantageous treatment option for elderly patients owing to its lower incidence of complications.There was no evidence of publication bias in the included literature, and the results demonstrated robustness following sensitivity analysis.
Keywords: Meta-analysis, Submucosal tunnel endoscopic resection, Upper Gastrointestinal submucosal tumors, Ster, SMTs
Received: 28 Apr 2025; Accepted: 21 Jul 2025.
Copyright: © 2025 Liu, Ma and Zhu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Linlin Zhu, West China Hospital, Sichuan University, Chengdu, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.