Endoscopic resection of gastrointestinal stromal tumors

Abstract

Surgical resection is regarded as the main modality for the treatment of gastrointestinal stromal tumors (GISTs). With the advancement of endoscopic techniques and the concept of super minimally invasive surgery (SMIS), endoscopic resection has been an alternative option for surgery. Recently, various endoscopic resection techniques have been used for the treatment of GISTs, including endoscopic submucosal dissection (ESD), endoscopic submucosal excavation (ESE), endoscopic full‐thickness resection (EFR), submucosal tunneling endoscopic resection (STER), and laparoscopic and endoscopic cooperative surgery (LECS). Studies on the safety and efficacy of endoscopic treatment of GISTs have emerged in recent years and have demonstrated that endoscopic resection techniques are effective and safe for the treatment of GISTs. However, there is currently no consensus on the optimal follow‐up strategy and the appropriate tumor size cutoff value for ER treatment. This review aims to discuss the indications, preoperative preparation, procedures, efficacy, safety, postoperative evaluation, follow‐up, and perspectives of ER for GISTs.This article is protected by copyright. All rights reserved.

Safety and efficacy of a modified endoscopic full-thickness resection technique for gastric submucosal tumors: a case series

“…Gastric submucosal tumors (SMTs) are common neoplasms observed during upper gastrointestinal endoscopy, with an incidence rate of approximately 0.36% ( 1 ). While most SMTs are benign, up to 13% have malignant potential, particularly those originating from the muscularis propria layer ( 2 ).…”

“…The premise of ER for SMTs is the absence of metastasis, and the goal is complete resection without major morbidity. For SMTs originating from the muscularis propria layer and potentially closely adhering to the serosal layer, endoscopic full-thickness resection (EFTR) is preferred under endoscopy ( 1 ). However, EFTR intentionally perforates and removes the entire tumor within the gastric wall, which may damage the rich vascular network outside the serosa layer.…”

Mucosal snare resection-endoscopic submucosal excavation: a novel technology

“…Endoscopic submucosal excavation (ESE) is a less invasive therapeutic alternative to surgical resection for the removal of gastric submucosal tumors [1]. The conventional procedural steps of this technique all involve cautery markings to delineate the target lesion, followed by submucosal injection and the resection of the lesion using a hook knife, insulation-tipped knife, or dual knife, and finally, closure of the mucosal incision using clips [2]. We report a novel variant ESE technique, mucosal snare resection-endoscopic submucosal excavation (MSR-ESE), for a lower technical burden and shorter procedure time compared with ESE.…”