The endosonographic data of 167 patients who underwent endoscopic submucosal dissection at the Tianjin Medical University General Hospital, China between 2009 and 2011 were analyzed. GISTs and
leiomyomas had a similar intragastric distribution and similar locations within the gastric wall. Therefore, patients with GISTs were chosen as the study group and those with
leiomyomas were chosen as the control group.
Dyspepsia symptom questionnaires were used to investigate and compare the gastrointestinal symptoms of patients with GISTs and those with gastric
leiomyomas before and after endoscopic submucosal dissection (ESD). The questionnaires evaluated symptoms such as epigastric
pain,
heartburn, regurgitation, epigastric discomfort,
nausea and
vomiting, abdominal bloating, and
eructation. Symptoms were assessed using a four-point scoring scale.
RESULTS: GISTs were the most common gastric submucosal lesion (67 cases, 40.12%), followed by
leiomyomas (38 cases, 22.75%). Both groups were similar in terms of gender distribution (P = 0.49), intragastric location (P = 0.525), and originating layer within the gastric wall (P = 0.449), but
leiomyomas were more commonly found in the proximal fundus (P < 0.05). Overall, 94.2% of the patients with small GISTs and 93.5% of those with gastric
leiomyomas experienced some
dyspepsia; however, total symptom scores were significantly lower in the GIST group than in the
leiomyoma group (1.34 ± 1.27 vs 2.20 ± 1.70, P < 0.05). Each component of the symptom score demonstrated a statistically significant improvement in the GIST patients after ESD (P < 0.05), including epigastric
pain (0.80 ± 0.90 vs 0.13 ± 0.46),
heartburn (0.63 ± 1.08 vs 0.13 ± 0.41), regurgitation (0.55 ± 0.87 vs 0.22 ± 0.57), epigastric discomfort (0.70 ± 0.98 vs 0.32 ± 0.47),
nausea and
vomiting (0.27 ± 0.62 vs 0.05 ± 0.21), abdominal bloating (0.70 ± 0.90 vs 0.27 ± 0.49), and
eructation (0.36 ± 0.61 vs 0.21 ± 0.46). For
leiomyoma patients, symptoms such as
heartburn,
nausea,
vomiting, and
eructation improved
after treatment; however, these improvements were not statistically significant (P > 0.05). Thus, the pathophysiology of
dyspepsia symptoms may be different between the two groups.
CONCLUSION: