Endoscopic resection of gastrointestinal submucosal tumors assisted by endoscopic ultrasonography

Martı́nez-Ares, David; Lorenzo, M. J. Varas; Souto-Ruzo, José; Pérez, J. C. Espinós; López, J. Yáñez; Belando, Ramón Abad; Vilas, J. Durana; Colell, J. M. Miquel; Iglesias, José

doi:10.1007/s00464-004-9123-3

Cited by 16 publications

(14 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…10 Resection of these lesions using the laparoscopic approach, with or without the help of simultaneous intraoperative endoscopy, allows diagnosis and a minimally invasive treatment. [6][7][8][9][10]13 In our casuistry, 4 cases with the preoperative suspicion of gastric GIST had a final definitive Laparoscopic Resection of Clinically Suspected Gastric Stromal Tumors / Berindoague et al 233 diagnosis of adenomyoma, hamartoma, parasitic tumor (anisakis), or plasmocytoma. Three of the 4 underwent laparoscopic wedge resection.…”

Section: Discussionmentioning

confidence: 93%

“…In certain locations, diagnosis is difficult to establish even with endoscopic ultrasonography, and resection by fibergastroscopy in lesions of larger than 3 cm is not always possible. 11,13 In our casuistry, endoscopic ultrasonography was made in 7 patients, with correct diagnosis in 4 of them. According to Iwahashi and colleagues, 14 the sensitivity and specificity of preoperative differential diagnosis for gastric GIST using endoscopic ultrasonography were 83.3% and 66.7%, respectively.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Laparoscopic Resection of Clinically Suspected Gastric Stromal Tumors

Berindoague

Targarona

Feliu³

et al. 2006

Surg Innov

View full text Add to dashboard Cite

Gastrointestinal stromal tumors (GISTs) account for 5% of all gastric tumors. Preoperative diagnosis is relatively difficult because biopsy samples are rarely obtained during fibergastroscopy. Surgical radical resection is the gold standard treatment, allowing pathologic study for both diagnosis and prognosis. Laparoscopic resection has become an alternative to the open approach, but long-term results are not well known. The aim of this study is to report experience with laparoscopic resection, placing special emphasis on preoperative diagnosis and describing long-term results. A retrospective analysis was made of all patients undergoing a laparoscopic resection for clinically suspected gastrointestinal stromal tumors between November 1998 and August 2006 at 2 tertiary hospitals. The medical records of all participants were reviewed regarding surgical technique, clinicopathologic features, and postoperative long-term outcome. Laparoscopic gastric resection was attempted in 22 patients (13 women and 9 men) with a mean age of 66.7 years (range, 29-84 years). One patient had 2 gastric tumors. Tumor localization was upper gastric third in 6 patients, mid-gastric third in 7, and distal third in 10. Surgical techniques were transgastric submucosal excision (n = 1), wedge resection (n = 13), partial gastrectomy with Y-en-Roux reconstruction (n = 6), and total gastrectomy with Y-en-Roux reconstruction (n = 2). Two patients (9.1%) required conversion to the open procedure because of tumor size. Postoperative morbidity was delayed gastric emptying in 3 patients. Median postoperative stay was 6 days (range, 4-32 days). Pathologic and immunohistochemical study confirmed gastrointestinal stromal tumors in 18 cases. The other 4 cases were adenomyoma, hamartoma, plasmocytoma, and parasitic tumor (anisakis). Median tumor size was 5.6 cm (range, 2.5-12.5 cm) in cases of gastrointestinal stromal tumors. Malignant risk of gastrointestinal stromal tumors assessed according to mitotic index and size was low (n = 8), intermediate (n = 6), or high (n = 4). After a median follow-up of 32 months (range, 1-72 months), there was 1 case of recurrence of GIST. Definitive preoperative diagnosis of gastric submucosal tumors is frequently difficult. The laparoscopic approach to surgical treatment of these tumors seems safe and is associated with acceptable intermediate-term results, especially in cases of gastrointestinal stromal tumors.

show abstract

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Laparoscopic Resection of Clinically Suspected Gastric Stromal Tumors

Berindoague

Targarona

Feliu³

et al. 2006

Surg Innov

View full text Add to dashboard Cite

show abstract

“…This technique has the advantage of simultaneously providing a definitive diagnosis and therapy of smaller lesions (up to 20 mm in size) with the main complications being bleeding (4-13%) and perforation (up to 5%). [54555657] A study by Cantor et al . compared the diagnostic yield between forceps biopsies using the bite-on-bite technique and ESMR for subepithelial lesions.…”

Section: Alternatives To Fnamentioning

confidence: 99%

When to puncture, when not to puncture: Submucosal tumors

Salah

Faigel

2014

Endosc Ultrasound

View full text Add to dashboard Cite

Subepithelial masses of the gastrointestinal (GI) tract are a frequent source of referral for endosonographic evaluation. Subepithelial tumors most often appear as protuberances in the GI tract with normal overlying mucosa. When there is a need to obtain a sample of the mass for diagnosis, endoscopic ultrasound (EUS) - guided fine-needle aspiration (FNA) is superior to other studies and should be the first choice to investigate any subepithelial lesion. When the decision is made to perform EUS-guided FNA several technical factors must be considered. The type and size of the needle chosen can affect diagnostic accuracy, adequacy of sample size and number of passes needed. The use of a stylet or suction and a fanning or standard technique during EUS-guided FNA are other factors that must be considered. Another method proposed to improve the efficacy of EUS-guided FNA is having an on-site cytopathologist or cytotechnician. Large or well-differentiated tumors may be more difficult to diagnose by standard EUS-FNA and the use of a biopsy needle can be used to acquire a histopathology sample. This can allow preservation of tissue architecture and cellularity of the lesion and may lead to a more definitive diagnosis. Alternatives to FNA such as taking bite-on-bite samples and endoscopic submucosal resection (ESMR) have been studied. Comparison of these two techniques found that ESMR has a significantly higher diagnostic yield. Most complications associated with EUS-FNA such as perforation, infection and pancreatitis are rare and the severity and incidence of these adverse events is not known. Controversy exists as to the optimal method in which to perform EUS-FNA and larger prospective trials are needed.

show abstract

“…It can also identify the wall layer of origin and the echotexture of the lesion to aid in diagnosis [6]. Pneumatosis cystoides intestinales, gastrointestinal stromal tumors (GISTs), lipomas, mucoceles, endometriosis, and carcinoid tumors have been characterized using miniprobe catheters [7–10]. …”

Section: Introductionmentioning

confidence: 99%

Evaluation of Subepithelial Abnormalities of the Appendix by Endoscopic Ultrasound

Uradomo

Darwin

2009

Diagnostic and Therapeutic Endoscopy

View full text Add to dashboard Cite

Background. The use of through-the-scope (TTS) miniprobe catheter endoscopic ultrasound is a valuable technique for evaluating subepithelial lesions in the proximal colon. Few reports include the evaluation of the appendix by EUS. Objective. To describe endoscopic and endosonographic characteristics of subepithelial lesions of the appendix. Methods. Retrospective case series in a single academic medical center. Adult patients referred for evaluation of subepithelial lesions of the appendix identified by colonoscopy between April 1, 2003 to February 29, 2008. Data were abstracted from an electronic endoscopic database for all patients undergoing miniprobe endoscopic ultrasound examination of the appendix. Medical records were reviewed for patient followup and outcomes. Results. Nine cases were identified. Seven (78%) patients were female. Seven (78%) utilized the 12 MHz miniprobe device and two (22%) used the 20 MHz device. Three mucoceles were described and confirmed by surgical resection. Cases also included one inverted appendix, one gastrointestinal stromal tumor, and one lipoma. In three cases, no abnormality was found. Conclusions. EUS evaluation of the appendix is feasible with standard miniprobe devices and may assist in the selection of patients who may benefit from surgical management.

show abstract

Endoscopic resection of gastrointestinal submucosal tumors assisted by endoscopic ultrasonography

Abstract: The endoscopic resection of submucosal tumors is a safe and efficient technique: It has few associated complications and allows diagnosis in all the cases and cure of the lesion in the great majority of cases.

Cited by 16 publications

References 21 publications

Laparoscopic Resection of Clinically Suspected Gastric Stromal Tumors

Laparoscopic Resection of Clinically Suspected Gastric Stromal Tumors

When to puncture, when not to puncture: Submucosal tumors

Evaluation of Subepithelial Abnormalities of the Appendix by Endoscopic Ultrasound

Contact Info

Product

Resources

About