The Usefulness of Endoscopic Subtumoral Dissection for En-bloc Resection of Upper Gastrointestinal Submucosal Tumor.
- Author:
Hyo Joong YOON
1
;
Chang Beom RYU
;
Hyun Sik NA
;
Ju Hee MAENG
;
Sang Hoon HAN
;
Bong Min KO
;
Su Jin HONG
;
Joo Young CHO
;
Joon Seong LEE
;
Moon Sung LEE
;
Chan Sup SHIM
;
Boo Sung KIM
Author Information
1. Department of Internal Medicine, Soonchunhyang University School of Medicine, Bucheon, Korea. mslee8597@hanmail.net
- Publication Type:Original Article
- Keywords:
Submucosal tumor;
Endoscopic subtumoral dissection;
En-bloc resection
- MeSH:
Endosonography;
Gastrointestinal Stromal Tumors;
Hemangioma;
Humans;
Leiomyoma;
Lipoma;
Muscles;
Pancreas;
Stomach
- From:Korean Journal of Gastrointestinal Endoscopy
2008;36(4):193-199
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: The removal of esophageal and gastric submucosal tumors is difficult using conventional endoscopic mucosal resection methods. This study examined the usefulness of an endoscopic subtumoral dissection for an en-bloc resection of submucosal tumors. METHODS: An endoscopic subtumoral dissection was attempted for an en-bloc resection in 15 submucosal tumors (M: F=10 : 5, 13 stomach, 2 esophagus). Before the procedures, endoscopic ultrasonography was performed in all cases. The procedure was carried out using various electrosurgical knives, such as an endoscopic submucosal dissection. RESULTS: Pathological and immunohistochemical studies confirmed a gastrointestinal stromal tumor in 6 cases. Other pathological diagnoses were made in 9 patients with submucosal lesions: leiomyoma (4), ectopic pancreas (3), lipoma (1), and hemangioma (1). An en-bloc resection was performed in 13 of the 15 tumors (86.7%). The mean specimen size was 29.5x21.1 mm. The mean procedure time was 49.4 minutes (range: 8~103 minutes). Gastric perforation was a complication in 2 cases with GIST. However, the two perforated cases were treated with endoscopic closure using endoclips and recovered without the need for surgery. CONCLUSIONS: An endoscopic subtumoral dissection technique is useful for an en-bloc resection of esophageal and gastric submucosal tumors. However, sufficient attention should be paid to the detection of perforations in the case of tumors with a proper muscle origin.
