Comparing precutting endoscopic band ligation-assisted resection vs ESD for small gastric SMTs: a randomized controlled trial
In brief
Band-assisted resection removed small gastric tumors in 17.5 minutes, versus 30 with ESD
In this randomized trial of gastric tumors 16 mm or smaller, band-assisted resection took a median 17.5 minutes, compared with 30 minutes for endoscopic submucosal dissection, and cost less. Both methods achieved complete removal in all patients, with no delayed perforations or recurrences reported; the single-center study used experienced endoscopists, so results in other settings need validation.
- Journal
- Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver (Q1)
- Published
- 29 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Youping Zhou, Mingfeng Liu, Rui Yuan, Yu Ou, Xiaofeng Yang, Haojie Zhang, et al.
- PMID
- 42957495
- DOI
- 10.1016/j.dld.2026.09.027
Why clinicians should know about it
- Picked for Gastroenterology (top studies of the week, 8 November 2026): Precutting EBLR reduces operation time versus ESD for gastric SMT
Abstract
BACKGROUND AND STUDY AIMS: This study evaluated the clinical feasibility of precutting endoscopic band ligation-assisted resection (precutting EBLR) for the removal of small gastric submucosal tumors originating from the muscularis propria (gSMT-MP). METHODS: This was a single-center, open-label, parallel-group randomized controlled trial (ChiCTR2200065473). All endoscopic procedures were performed by two experienced endoscopists (>300 ESD cases each). From January 2023 to December 2024, consecutive patients with gSMT-MP ≤ 16 mm were enrolled and randomly assigned to precutting EBLR or ESD. The primary outcome was operation time, additional clinical indicators were also collected and analyzed. RESULTS: The median operation time was 17.5 min (range: 12-50) for the precutting EBLR group and 30 min (range: 12-80) for the ESD group. The median operation costs were $564.05 (range: $301.97-$1236.42) and $849.29 (range: $491.95-$2121.25), respectively. R0 and en-bloc resection were achieved in all patients. No delayed perforations or tumor recurrences occurred during follow-up. CONCLUSION: Precutting EBLR demonstrated advantages in operation time compared with ESD. It represents an efficient and safe endoscopic approach for treating gSMT-MPs ≤ 16 mm, and may be potentially applicable in non-academic or lower-volume centers, pending further validation.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.