Endoscopic Resection of Small Gastrointestinal Stromal Tumors

Abstract

Endoscopic resection is feasible, safe, and effective for small-size gastric GISTs (<30 mm). Short-term follow-up evaluation merits favorable clinical results.

Endoscopic dissection of large endogenous myogenic tumors in the esophagus and stomach is safe and feasible: A report of 42 cases

“…However, endoscopic treatment alone has been limited to en bloc resection of endogenous tumors <2 cm in diameter or core removal [14]. More recently, as new instruments are developed and surgical techniques are improved, some studies, including the present study, report that endoscopic resection technique can directly remove gastric endogenous stromal tumors more than 2 cm in diameter.…”

Endoscopic Removal of Small Gastrointestinal Stromal Tumors: Can We GIST-ify the Risk?

“…In this article, Bai et al present the management of 25 patients with small gastric GISTs (\30 mm) [5]. Based on resection and natural history studies in the literature and even histologic evaluation of the data of Bai and colleagues, these types of lesions are benign.…”

“…The endoscopic removal of small GISTs by ESD is technically feasible as demonstrated in the article by Bai et al [5]. Its use, though, cannot be justified given that it carries a 28% perforation rate along with a potential prolonged hospital stay (4.26 days) for a very benign condition.…”

“…His technique, although effective, is not low risk. His study reports a 28% perforation rate (up to 6 mm in size) leading to a prolonged hospital stay (4.28 days) [5]. This figure is significantly higher than ESD (endoscopic submucosal dissection) done for other indications.…”

“…In this month's issue of Digestive Diseases and Sciences, Bai et al present an interesting article on the endoscopic removal of small GIST tumors (\30 mm) [5]. While the authors report a technical success with removal, we should be asking ourselves ''should we,'' rather than ''can we.''…”