Endoscopic full-thickness resection for gastric gastrointestinal stromal tumor originating from the muscularis propria

Abstract

SUMMARY OBJECTIVE: This study retrospectively reviewed 46 cases of gastric gastrointestinal stromal tumors treated by endoluminal endoscopic full-thickness resection (EFR) microsurgery in our gastrointestinal endoscopy center. We aimed to evaluate the EFR for the treatment of gastric gastrointestinal stromal tumors originating from the muscularis propria. METHODS: A total of 46 patients with gastric gastrointestinal stromal tumors originated from the muscularis propria layer from January 2012 to June 2015 were treated with EFR. The patients were followed up with gastroscope and computed tomography (CT) for evaluation of therapeutic effect and safety. RESULTS: EFR was successfully accomplished to remove all tumors in 46 patients. The mean procedure time was 82.5±39.8min (56-188min). Except in 3 leiomyomas, pathological examination confirmed gastrointestinal stromal tumor (GIST) in 43 cases. None of the patients had occurred bleeding, peritonitis and other complications after EFR. Thereafter, all patients were followed up with gastro-scope after 1, 6,12 months. CONCLUSIONS: EFR is effective and safe for patients with gastric gastrointestinal stromal tumors originated from muscularis propria layer and has the advantage of less invasive treatment and higher tumor resection rate. It should be considered for further application.

Therapeutic Effects of 4 Surgical Approaches for Small Gastrointestinal Stromal Tumors: A Network Meta-analysis

“…The flow diagram of literature screening is shown in Figure 1. Of the 24 studies, 21 were dual‑arm studies,11–31 whereas the remaining 3 were 3-arm studies 32–34. Moreover, 19 studies11,13–23,26–28,30–32,34 were from China, accounting for ~80% of included studies.…”

“…However, comprehensive comparison and systematic evaluation of ER, LR, LECS, and OpS are lacking. Therefore, we collected published clinical controlled studies on the comparison of ER, LR, LECS, and OpS in the treatment of small GISTs 11–34. Subsequently, a comprehensive comparative analysis was conducted with operative time, hospital stays, time to liquid diet, intraoperative bleeding, and complications as outcome indicators.…”

Application of NOTES combined with ESD for the treatment of an exogenous gastric stromal tumor: A case report and review of the literature

“…GIST, gastrointestinal stromal tumor; N/A, not available. for lesions derived from the muscularis propria and the serosal layer (31). However, EFR has a number of complications, such as perforation and bleeding, and needs to be performed by highly skilled surgeons.…”

A novel technique for endoscope progression in gastroscopy resection: “6”- turn of gastroscopy along the greater curvature wall for dissection of stromal tumor in the muscularis propria of the gastric fundus

“…The fundus of the stomach is considered a challenging area for ESD 17 , ESE, or EFTR 18,19 ; the ESD technique is complex and prone to perforation 21 , and the EFTR technique intentionally destroys the full thickness of the gastric wall, causing perforation to remove the lesion then sutures the wound by nylon suture and or hemostatic clips 22 . One of the current endoscopic treatments used for STMF is EFTR 16 .…”