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

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• 作者：Shuo Zhang (1)
  Guan-Qun Chao (2)
  Men Li (1)
  Gui-Bao Ni (3)
  Bin Lv (1)
  
• 关键词：Endoscopic submucosal dissection (ESD) ; Submucosal tumor (SMT) ; Therapeutic upper gastrointestinal endoscopy
• 刊名：Digestive Diseases and Sciences
• 出版年：2013
• 出版时间：June 2013
• 年：2013
• 卷：58
• 期：6
• 页码：1710-1716
• 全文大小：387KB
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• 作者单位：Shuo Zhang (1)
  Guan-Qun Chao (2)
  Men Li (1)
  Gui-Bao Ni (3)
  Bin Lv (1)
  
  1. Department of Gastroenterology, The First Affiliated Hospital, Zhejiang Chinese Medical University, Youdian Road No. 54, Hangzhou, 310006, China
  2. Department of Family Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Qingchun Road No. 3, Hangzhou, 310016, China
  3. Department of Pathology, The First Affiliated Hospital, Zhejiang Chinese Medical University, Youdian Road No. 54, Hangzhou, 310006, China
  
• ISSN：1573-2568

文摘

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 30-1?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-.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 50-20?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.