Endoscopic resection for gastric schwannoma with long-term outcomes
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Abstract
Background
Gastric schwannoma is not so recognized by clinicians as its counterparts. The efficacy of endoscopic resection has not been described yet. Our aim was to assess the efficacy and safety of endoscopic resection in the management of gastric schwannoma.
Methods
Retrospective data were reviewed from January 2008 to December 2013 in our center. Fourteen patients who had endoscopic resection with the final pathology result of gastric schwannoma were included in the study.
Results
Of the 14 patients, there were 12 females and two males. The median age was 59 years (range 32–83). Thirteen tumors (92.9 %) were from the muscularis propria and one located in the submucosa. Endoscopic en bloc resection was achieved in 12 patients (12/14, 85.7 %), including seven cases of endoscopic full-thickness resection (EFTR). The mean resected tumor size was 1.73 ± 1.10 cm (range 0.3–4.0 cm). In one case, endoscopic resection was suspended due to the limited experience of EFTR during the early period of the study. In another case, due to the difficult tumor location (gastric angle) and extraluminal growth pattern, the patient was referred to laparoscopic surgery. In the 12 successful endoscopic resection cases, during the median follow-up time of 4 years (range 17–77 months, one patient lost), no tumor residue, recurrence or metastasis was found.
Conclusions
Endoscopic resection is safe and effective in treating gastric schwannoma with excellent long-term outcomes. However, it should be performed with caution because schwannoma is mainly located in the deep muscular layer, which leads to the full-thickness resection of gastric wall.
Keywords
Gastric schwannoma Endoscopic full-thickness resection (EFTR) Endoscopic submucosal dissection (ESD)Notes
Acknowledgments
This study was supported by grants from the Major Project of Shanghai Municipal Science and Technology Committee (13411950801) (Dr. P.H.Z), the Academic Leader Training Project of Shanghai Municipal Commission of Health and Family Planning (13B038) (Dr. P.H.Z), and the National Natural Science Foundation of China (81470811, 81301760) (Dr. P.H.Z), (81305428) (Dr. M.Y.C).
Compliance with ethical standards
Disclosures
Doctors Ming-Yan Cai, Jia-Xin Xu, Ping-Hong Zhou, Mei-Dong Xu, Shi-Yao Chen, Jun Hou, Yun-Shi Zhong, Yi-Qun Zhang, and Li-Li Ma have no conflicts of interest or financial ties to disclose.
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