BACKGROUND: Gastric subepithelial tumors represent a diagnostic and therapeutic challenge, given their histologic heterogeneity and potential malignant behavior. OBJECTIVE: The objective of this article is to evaluate the interest, efficiency and safety of endoscopic resection for subepithelial gastric lesions of size <20 mm. METHODS: We conducted a single-center retrospective study in a tertiary care center. RESULTS: A total of 33 lesions (10 malignant/23 benign lesions) were studied. Mean histological size was 14.5 mm. Nine EMR, 18 ESD and six hybrid resections were performed. A total of 93.9% lesions were resected in one piece. At six months' follow-up, complete and definitive resection was obtained in 96.7% of cases. A vertical resection was insufficient in four cases. One GIST needed a complementary surgical resection, one neuroendocrine tumor was successfully treated by a new ESD session and two pancreatic rests were not additionally treated given the benign character and the absence of residual tissue in endoscopic control after six months. There was only one severe adverse event (2.9%); one pneumoperitoneum with ESD, three bleeding with one ESD and two EMR, always treated conservatively or endoscopically. CONCLUSION: Endoscopic resection is safe and should be the procedure of choice for both diagnosis and definitive resection of subepithelial gastric lesions of size under 20 mm.
BACKGROUND: Gastric subepithelial tumors represent a diagnostic and therapeutic challenge, given their histologic heterogeneity and potential malignant behavior. OBJECTIVE: The objective of this article is to evaluate the interest, efficiency and safety of endoscopic resection for subepithelial gastric lesions of size <20 mm. METHODS: We conducted a single-center retrospective study in a tertiary care center. RESULTS: A total of 33 lesions (10 malignant/23 benign lesions) were studied. Mean histological size was 14.5 mm. Nine EMR, 18 ESD and six hybrid resections were performed. A total of 93.9% lesions were resected in one piece. At six months' follow-up, complete and definitive resection was obtained in 96.7% of cases. A vertical resection was insufficient in four cases. One GIST needed a complementary surgical resection, one neuroendocrine tumor was successfully treated by a new ESD session and two pancreatic rests were not additionally treated given the benign character and the absence of residual tissue in endoscopic control after six months. There was only one severe adverse event (2.9%); one pneumoperitoneum with ESD, three bleeding with one ESD and two EMR, always treated conservatively or endoscopically. CONCLUSION: Endoscopic resection is safe and should be the procedure of choice for both diagnosis and definitive resection of subepithelial gastric lesions of size under 20 mm.
Authors: Vladimir M Kushnir; Rajesh N Keswani; Thomas G Hollander; Cara Kohlmeier; Daniel K Mullady; Riad R Azar; Faris M Murad; Srinadh Komanduri; Steven A Edmundowicz; Dayna S Early Journal: Gastrointest Endosc Date: 2015-02-07 Impact factor: 9.427
Authors: Christina Y Ha; Rajesh Shah; Jaijing Chen; Riad R Azar; Steven A Edmundowicz; Dayna S Early Journal: Gastrointest Endosc Date: 2009-05 Impact factor: 9.427
Authors: Hye Jin Tae; Hang Lak Lee; Kang Nyeong Lee; Dae Won Jun; Oh Young Lee; Dong Soo Han; Byung Chul Yoon; Ho Soon Choi; Joon Soo Hahm Journal: Endoscopy Date: 2014-08-11 Impact factor: 10.093
Authors: Heikki Joensuu; Aki Vehtari; Jaakko Riihimäki; Toshirou Nishida; Sonja E Steigen; Peter Brabec; Lukas Plank; Bengt Nilsson; Claudia Cirilli; Chiara Braconi; Andrea Bordoni; Magnus K Magnusson; Zdenek Linke; Jozef Sufliarsky; Massimo Federico; Jon G Jonasson; Angelo Paolo Dei Tos; Piotr Rutkowski Journal: Lancet Oncol Date: 2011-12-06 Impact factor: 41.316
Authors: Christopher D M Fletcher; Jules J Berman; Christopher Corless; Fred Gorstein; Jerzy Lasota; B Jack Longley; Markku Miettinen; Timothy J O'Leary; Helen Remotti; Brian P Rubin; Barry Shmookler; Leslie H Sobin; Sharon W Weiss Journal: Hum Pathol Date: 2002-05 Impact factor: 3.466
Authors: João Santos-Antunes; Margarida Marques; Rui Morais; Francisco Baldaque-Silva; Filipe Vilas-Boas; Pedro Moutinho-Ribeiro; Susana Lopes; Fátima Carneiro; Guilherme Macedo Journal: Ann Gastroenterol Date: 2021-11-10