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Digestive Diseases and Sciences

, Volume 58, Issue 6, pp 1710–1716 | Cite as

Endoscopic Submucosal Dissection for Treatment of Gastric Submucosal Tumors Originating from the Muscularis Propria Layer

  • Shuo Zhang
  • Guan-Qun Chao
  • Men Li
  • Gui-Bao Ni
  • Bin LvEmail author
Original Article

Abstract

Background and Aims

We aimed to study the feasibility of endoscopic submucosal dissection (ESD) for the removal of gastric muscularis propria tumors and to evaluate the efficacy and safety of ESD for this treatment.

Methods

Eighteen patients with gastric SMTs originating from the muscularis propria were treated by ESD between July 2008 and July 2011. Tumor characteristics, complications, en bloc resection rate, and local recurrence rate were evaluated.

Results

Among the 18 patients, 11 were women (61.1 %). The median age was 65.3 ± 6.3 years old (range 30–71 years old). Seventeen tumors were resected completely by ESD (success rate 94.4 %). The mean tumor size as determined by endoscopic ultrasound was 2.6 ± 1.2 cm (range 1.0–3.5 cm). The histological diagnosis was gastrointestinal stromal tumor for 13 lesions and leiomyoma for four tumors. The mean operation time was 90 ± 38 min (range 50–120 min), and the average blood loss was 20 ml. Two patients developed perforation, which was closed by endoscopic methods with metallic clips. The tumor was closely adhered to the muscularis propria and was convex to the enterocoelia in one case. No single case had severe complications, such as GI bleeding, peritonitis, or abdominal abscess, and there were no other immediate post-procedure complications.

Conclusions

ESD is a safe, effective, well-tolerated, and minimally invasive therapy for the intraluminal SMTs originating from gastric muscularis propria with relatively few complications. Although there is a risk of perforation which has become manageable endoscopically.

Keywords

Endoscopic submucosal dissection (ESD) Submucosal tumor (SMT) Therapeutic upper gastrointestinal endoscopy 

Notes

Conflict of interest

We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work, there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of, the manuscript entitled.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Shuo Zhang
    • 1
  • Guan-Qun Chao
    • 2
  • Men Li
    • 1
  • Gui-Bao Ni
    • 3
  • Bin Lv
    • 1
    Email author
  1. 1.Department of Gastroenterology, The First Affiliated HospitalZhejiang Chinese Medical UniversityHangzhouChina
  2. 2.Department of Family Medicine, Sir Run Run Shaw HospitalZhejiang UniversityHangzhouChina
  3. 3.Department of Pathology, The First Affiliated HospitalZhejiang Chinese Medical UniversityHangzhouChina

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