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Endoscopic Treatment of Subepithelial Lesions of the Gastrointestinal Tract

  • Endoscopy (P Siersema, Section Editor)
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Abstract

Purpose of Review The study aimed to discuss novel endoscopic approaches to resection of submucosal lesions.

Recent Findings Endoscopic resection by excavation, full-thickness resection, and submucosal tunneling are by now well-documented techniques for submucosal tumor resection. Combined approaches with laparoscopy such as several variations of laparoscopic endoscopic cooperation surgery (LECS) and non-exposed wall-inversion surgery (NEWS) are also possible now. Reports of these approaches show good results. However, lesion size is the main limitation to these approaches.

Summary Endoscopic submucosal tumor resection can be effectively done endoscopically or by endoscopy combined with laparoscopy. These techniques allow localized resection of lesions at difficult locations such as in the gastroesophageal junction with limited influence on the normal anatomy. Variations in techniques are being practiced worldwide striving to achieve complete resection with minimal disturbance of function or contamination. The choice between approaches depends largely on the size and site of the lesion and expertise available.

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Authors and Affiliations

  1. Division of Upper GI and Metabolic Surgery, Department of Surgery, Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong SAR

    Vivien Wai Yin Wong MBChB, FRCSEd & Philip Wai Yan Chiu MD, FRCSEd

  2. Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan

    Osamu Goto MD, PhD

  3. Department of Surgery, Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong SAR

    Hans Gregersen MD, PhD, MPM

  4. Department of Surgery, Prince of Wales Hospital, 4/F Lui Che Woo Clinical Sciences Building, Shatin, New Territories, Hong Kong SAR

    Philip Wai Yan Chiu MD, FRCSEd

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  1. Vivien Wai Yin Wong MBChB, FRCSEd
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  2. Osamu Goto MD, PhD
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  3. Hans Gregersen MD, PhD, MPM
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  4. Philip Wai Yan Chiu MD, FRCSEd
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Correspondence to Philip Wai Yan Chiu MD, FRCSEd.

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Vivien Wai Yin Wong declares that she has no conflict of interest. Osamu Goto declares that he has no conflict of interest. Hans Gregersen declares that he has no conflict of interest. Philip Wai Yan Chiu declares that he has no conflict of interest.

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Wong, V.W.Y., Goto, O., Gregersen, H. et al. Endoscopic Treatment of Subepithelial Lesions of the Gastrointestinal Tract. Curr Treat Options Gastro 15, 603–617 (2017). https://doi.org/10.1007/s11938-017-0152-0

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