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Is it enough to observe less than 2 cm sized gastric SET?

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Abstract

Background and aims

The recent surge in demand for screening endoscopy has led to an increased detection of gastric subepithelial tumors (SETs). According to current guideline, SETs less than 2 cm in size are recommended for periodic surveillance. In light of recent advancement in therapeutic endoscopy in resection of small SET, we analyzed the histopathological features and the effectiveness of endoscopic resection for these small SETs.

Methods

Retrospectively study was performed on 74 patients who underwent endoscopic resection of gastric small (≤ 2 cm) upper gastrointestinal tract SETs. The outcomes including histopathology and en bloc resection were analyzed.

Results

The mean SET size was 11.69 ± 5.11 mm. The mean procedure time was 81.26 ± 42.53 min. Of the 74 patients, 28 patients had leiomyomas, 26 had gastrointestinal stromal tumors (GISTs), 14 had ectopic pancreas, 4 had lipomas, and 2 had neuroendocrine tumors. Among those with GIST, two patients exhibited high-risk histology. All patients underwent successful and uneventful endoscopy.

Conclusions

Endoscopic resection can be recommended even for the small gastric SETs. In our study, we found that SETs with a size of less than 2 cm have significant proportion of GISTs which harbor malignant transformation potential.

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Abbreviations

SET:

Subepithelial tumor

GIST:

Gastrointestinal stromal tumor

EMR:

Endoscopic mucosal resection

ESD:

Endoscopic submucosal dissection

OTSC:

Over-the-scope clip

IT Knife:

Insulated-tipped electrosurgical knife

APC:

Argon plasma coagulation

ET:

Endoscopic treatment

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, Cha Bundang Medical Center, Cha University College of Medicine, Seongnam-si, South Korea

    In Kyung Yoo, Seung Yoon Choi & Dae Suk Noh

  2. Division of Gastroenterology, Department of Internal Medicine, Gangnam Cha Medical Center, Cha University College of Medicine, 569, Nonhyon-ro Gangnam-gu, Seoul, South Korea

    Young Kwan Cho, Seong Whan Kim & Joo Young Cho

  3. Division of Gastroenterology, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea

    Jae Young Jang

  4. Division of Gastroenterology, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea

    Gwang Ho Baik

  5. Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, OH, USA

    Sunguk Jang & John Vargo

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  1. In Kyung Yoo
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Correspondence to Joo Young Cho.

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Disclosures

In Kyung Yoo, Young Kwan Cho, Seong Whan Kim, Seung Yoon Choi, Dae Suk Noh, Jae Young Jang, Gwang Ho Baik, Sunguk Jang, John Vargo and Joo Young Cho have no conflicts of interest or financial ties to disclose.

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In Kyung Yoo and Young Kwan Cho contributed equally to this work as first authors.

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Yoo, I.K., Cho, Y.K., Kim, S.W. et al. Is it enough to observe less than 2 cm sized gastric SET?. Surg Endosc 37, 6798–6805 (2023). https://doi.org/10.1007/s00464-023-10110-0

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  • DOI: https://doi.org/10.1007/s00464-023-10110-0

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