The incidence of neuroendocrine neoplasms (NEN) is increasing globally, and gastrointestinal NEN (GI-NEN) is the most common type of NEN. Diagnosis and treatment of GI-NEN are quite different, according to tumor's location, size, background, cell origin, and pathogenesis. Digestive endoscopy has unique advantages in detecting of GI-NEN. However, endoscopist should not perform endoscopic resection arbitrarily, due to the high heterogeneity and complexity of GI-NEN. We need to establish the concept about comprehensive assessment for GI-NEN, including medical history and physical signs, serology, imaging, radionuclide and end·oscopic examination, to make an individualized treatment after rigorous multidisciplinary discussion.
Endoscopy, Gastrointestinal ; Gastrointestinal Neoplasms/surgery* ; Humans ; Incidence ; Neuroendocrine Tumors/surgery*

*Endoscopy ; *Endoscopy, Gastrointestinal ; Gastric Mucosa/*surgery ; Gastrointestinal Neoplasms/surgery ; Gastrointestinal System/surgery ; Human ; Intestinal Mucosa/*surgery

*Endoscopy ; *Endoscopy, Gastrointestinal ; Gastric Mucosa/*surgery ; Gastrointestinal Neoplasms/surgery ; Gastrointestinal System/surgery ; Human ; Intestinal Mucosa/*surgery

Submucosal tumors (SMTs) are occasionally found in the gastrointestinal tract during endoscopy. Endoscopic ultrasonography(EUS) can not reliably distinguish benign from malignant SMTs, because the exact histopathologic features of the lesion can not be defined. With the introduction of endoscopic submucosal dissection(ESD), gastrointestinal SMTs can be diagnosed and resected endoscopically. The purpose of this article is to elucidate the indication, method and efficacy of endoscopic resection of gastrointestinal SMTs.
Dissection ; Endoscopy ; Endosonography ; Gastrointestinal Neoplasms ; surgery ; Humans

Gastric gastrointestinal stromal tumor(GIST) is the most common mesenchymal neoplasms of the gastro-intestinal tract.For its unique biological behavior with KIT gene expression and the particular clinical characteristics with the recurrent nature, surgery and molecular targeted therapy is the main treatment of gastric GIST. Laparoscopic technology has been used in the surgical treatment of gastric GIST and is the future trend. In this article, we shed some light on the standardize surgical procedures of radical laparoscopic gastrectomy, obeying the surgical principles, accurate intraoperative localization, and surgery combined with targeted therapy.
Gastrectomy ; Gastrointestinal Stromal Tumors ; surgery ; Humans ; Laparoscopy ; Stomach Neoplasms ; surgery

Blue rubber bleb nevus syndrome (BRBNS) is a rare condition characterised by venous malformations in the skin, gastrointestinal tract and other parts of the body. Its presentation is usually sporadic, although cases of autosomal dominant inheritance have been reported. Usually seen in children, BRBNS presentation in adults is rare. Symptoms at presentation depend on the organs involved; patients with BRBNS may present with acute or chronic gastrointestinal bleed. We herein report a rare presentation of BRBNS in an adult who suffered from intermittent abdominal pain and melaena for three years. Contrast-enhanced computed tomography revealed a jejunojejunal intussusception with a vascular malformation as the lead point. The patient underwent laparotomy with resection of the intussuscepted bowel segment. Recovery was uneventful. In spite of a wide range of therapeutic options for the management of BRBNS described in the literature, the efficacy of those available therapies, including surgical excision, is not well established.
Adult ; Gastrointestinal Hemorrhage ; etiology ; surgery ; Gastrointestinal Neoplasms ; complications ; surgery ; Humans ; Male ; Nevus, Blue ; complications ; surgery ; Skin Neoplasms ; complications ; surgery

The art and science of gastrointestinal endoscopy will continue to evolve at an amazing pace, with both endoscopists and industry providing new techniques and technologies for us to learn, investigate and apply to the benefit of our patients. It is not difficult to imagine that the next decade may see the maturation of a distinct specialty of gastrointestinal endoscopic surgery, currently in its adolescence, which crosses traditional boundaries. Practitioners will originate from a variety of backgrounds--gastroenterological, surgical or radiological--but must be trained specifically to perform the wide range of endoscopic procedures already in existence and those continually being introduced. Such 'endotherapists' will be an integral part of multidisciplinary units where optimal management strategies are planned based on available scientific evaluation of techniques irrespective of who performs them. Currently, numerous gastroinestinal diseases including both benign and malignant conditions have been managed using only endoscopic measurements. Control of gastrointestinal bleeding (variceal and non-variceal), dilation of benign and malignant strictures, antireflux management for esophagogastric reflux, endoscopic curative resection of premalignant and malignant lesions, treatment of submucosal tumors, percutaneous endoscopic gastrostomy or jejunostomy, stenting for malignant stricture of hollow viscus or pancreaticobiliary diseases, tumor ablation, and removal of biliary or pancreatic duct stones, etc. have been widely performed and various fascinating techniques and instruments have been continuously developed. It would be difficult to handle all of these various treatment modalities in a limited space. In this review we would like to discuss the fields of gastrointestinal tumors.
Endoscopy, Digestive System* ; Esophageal Neoplasms/surgery ; Gastrointestinal Neoplasms/surgery* ; Human ; Palliative Care ; Stents ; Stomach Neoplasms/surgery

Surgery is the only possible cure protocol of gastrointestinal stromal tumor (GIST). But the risk of recurrence exists constantly. Risk assessment of relapse is very important to guide the targeted adjuvant therapy and predict the prognosis. Although the variables and grading in the risk assessment of recurrence after complete resection of primary local GIST have been identified, but either the F/NIH consensus, AFIP standards, modified NIH standards, or risk identification methods attempted to apply mathematical calculation model in recent years, including Jason S Gold risk nomogram, Rossi nomogram, Joensuu high Hotline Dengjun, are short of long-term, large-scale clinical trials without selection bias. Therefore, recurrence risk probability cannot be predicted accurately.
Gastrointestinal Neoplasms ; surgery ; Gastrointestinal Stromal Tumors ; surgery ; Humans ; Neoplasm Recurrence, Local ; Risk Assessment

In recent years, with the development of digestive endoscopy, endoscopic submucosal dissection(ESD) and its derived techniques including endoscopic submucosal excavation(ESE), submucosal tunnelling endoscopic resection(STER) and laparoscopic endoscopic combined surgery(LECS), can cure most of the gastric gastrointestinal stromal tumor(GIST). This article reviews the indication, method and evaluation of endoscopic resection for gastric GIST.
Endoscopy, Gastrointestinal ; methods ; Gastrointestinal Stromal Tumors ; surgery ; Humans ; Stomach Neoplasms ; surgery

Gastrointestinal Neoplasms ; Humans ; Intestinal Neoplasms/surgery* ; Neuroendocrine Tumors/pathology* ; Pancreatic Neoplasms/surgery* ; Stomach Neoplasms/pathology*