Endoscopic Enucleation Is Effective and Relatively Safe in Small Gastric Subepithelial Tumors Originating from Muscularis Propria
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Gastric subepithelial tumors originating from muscularis propria (MP) are usually benign, but some have malignant potential.
The aim of this study was to evaluate the utility of endoscopic enucleation for the diagnosis and treatment of MP tumors.
Patients and Methods
From January 2010 to February 2018, eighty patients with gastric MP tumors underwent endoscopic enucleation at our hospital. Band ligation and resection (BLR) or endoscopic muscularis resection (EMD) was performed based on considerations of tumor size (≤ 12 mm or > 12 mm). Tumor characteristics, procedure times, complete resection rates, adverse events and recurrence were analyzed.
Eighty patients with 82 lesions were eligible for inclusion in this study. BLR was used to treat 41 lesions. For these lesions, mean tumor size was 9.5 mm, median procedural time was 17.6 min (range 4–52), and the endoscopic complete resection rate was 100% (41/41). Perforation was developed in four patients, and was closed by endoscopic clipping. EMD was used to treat 41 lesions. Median procedure time was 66.1 min (range 12–260) and the endoscopic complete resection rate was 85.4% (35/41). Perforation occurred in eight patients, four patients received endoscopic treatment and four underwent surgery. Tumor recurrence was not observed in any patient over follow-up (mean 26.3 months).
Endoscopic enucleation appears to offer an effective, relatively safe means for diagnosing and treating gastric subepithelial tumors originating from the MP, and BLR provides a straightforward, effective, and relatively safe treatment for small MP tumors (≤ 12 mm).
KeywordsStomach neoplasms Gastrointestinal stromal tumors Leiomyoma Endoscopy
Eun Jung Ko and Byoung Wook Bang made substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data. Kye Sook Kwon and Yong Woon Shin made substantial contribution to acquisition of data. Hyung Kil Kim has been involved in drafting the manuscript or revising it critically for important intellectual content.
This work was supported by Inha University Research Grant (2017).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no competing interests.
Ethics approval and consent to participate
This was a retrospective study. Informed consent was obtained from all patients before the procedure, and this study was approved by the institutional review board of Inha University Hospital. (2014-01-102).
Availability of data and materials
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
- 5.Casali P, Jost L, Reichardt P, Schlemmer M, Blay J. Gastrointestinal stromal tumours: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol. 2009;20:64–67.Google Scholar
- 6.Blackstein ME, Blay J, Corless C, et al. Gastrointestinal stromal tumours: consensus statement on diagnosis and treatment. Can J Gastroenterol Hepatol. 2006;20:157–163.Google Scholar
- 7.Demetri GD, von Mehren M, Antonescu CR, et al. NCCN Task Force report: update on the management of patients with gastrointestinal stromal tumors. J Natl Compr Cancer Netw. 2010;8:S1-41. quiz S42-4.Google Scholar
- 29.Sun M, Song J, Song X, Liu B. Endoscopic full-thickness resection for gastric subepithelial tumors originating from the muscularis propria: A 69-case series. Surg Laparosc Endosc Percutan Tech. 2018;28:e12–e17.Google Scholar