Qiang Zhang1, Yue Li2, Zhou-Yang Lian3, Zhen Wang2, Li-Hui Wang2, Yang Bai2, Si-de Liu4. 1. Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, No.1838, North of Guangzhou Avenue, Guangzhou, 510515, Guangdong Province, China. 4024313@qq.com. 2. Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, No.1838, North of Guangzhou Avenue, Guangzhou, 510515, Guangdong Province, China. 3. Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, No. 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong Province, China. 4. Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, No.1838, North of Guangzhou Avenue, Guangzhou, 510515, Guangdong Province, China. side_liu2030@163.com.
Abstract
BACKGROUND AND OBJECTIVE: Endoscopic mucosa-sparing lateral dissection (EMSLD) was developed by our group, and is used to remove gastric submucosal tumor (SMT). This study aims to evaluate the feasibility and safety of this method. METHODS: This retrospective study included 25 patients who underwent EMSLDs at an endoscopy center as a national key unit in china from October 2015 to July 2016. The main data collected were the size of the gastric SMT, its location and origin, en bloc resection rate, operating time, intraoperative and postoperative complications, hospitalization expense, hospital days, and follow-up after hospital discharge. RESULTS: The mean (SD) size of the gastric SMTs was 18.3 (5.9) mm; 96% (24/25) of the tumors originated in the muscularis propria; and 64% (16/25) and 28% (7/25) were located in the gastric fundus and gastric body, respectively. The rate of en bloc resection was 96% (24/25), and the rate of intraoperative perforations due to endoscopic full-thickness resection was 48% (12/25). All wounds and perforations were effectively closed using endoscopic clips combined with the retained mucosa. The mean operative time was 74.2 (38.0) min. Delayed bleeding and perforation were not observed. CONCLUSION: Endoscopic mucosa-sparing lateral dissection is safe and feasible for the removal of gastric SMTs. The wound can be effectively closed using the retained mucosa and endoscopic clips, even if perforation has occurred. EMSLD provides an alternative to the resection of gastric SMTs, especially for tumors with a risk of intraoperative perforation.
BACKGROUND AND OBJECTIVE: Endoscopic mucosa-sparing lateral dissection (EMSLD) was developed by our group, and is used to remove gastric submucosal tumor (SMT). This study aims to evaluate the feasibility and safety of this method. METHODS: This retrospective study included 25 patients who underwent EMSLDs at an endoscopy center as a national key unit in china from October 2015 to July 2016. The main data collected were the size of the gastric SMT, its location and origin, en bloc resection rate, operating time, intraoperative and postoperative complications, hospitalization expense, hospital days, and follow-up after hospital discharge. RESULTS: The mean (SD) size of the gastric SMTs was 18.3 (5.9) mm; 96% (24/25) of the tumors originated in the muscularis propria; and 64% (16/25) and 28% (7/25) were located in the gastric fundus and gastric body, respectively. The rate of en bloc resection was 96% (24/25), and the rate of intraoperative perforations due to endoscopic full-thickness resection was 48% (12/25). All wounds and perforations were effectively closed using endoscopic clips combined with the retained mucosa. The mean operative time was 74.2 (38.0) min. Delayed bleeding and perforation were not observed. CONCLUSION: Endoscopic mucosa-sparing lateral dissection is safe and feasible for the removal of gastric SMTs. The wound can be effectively closed using the retained mucosa and endoscopic clips, even if perforation has occurred. EMSLD provides an alternative to the resection of gastric SMTs, especially for tumors with a risk of intraoperative perforation.
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: Tessa Verlaan; Rogier P Voermans; Mark I van Berge Henegouwen; Willem A Bemelman; Paul Fockens Journal: Gastrointest Endosc Date: 2015-05-21 Impact factor: 9.427
Authors: In Ho Jeong; Ji Hun Kim; Sang Rim Lee; Jin Hong Kim; Jae Chul Hwang; Sung Jae Shin; Kee Myung Lee; Hoon Hur; Sang Uk Han Journal: Surg Laparosc Endosc Percutan Tech Date: 2012-06 Impact factor: 1.719