Ligation-assisted endoscopic submucosal resection with apical mucosal incision to treat gastric subepithelial tumors originating from the muscularis propria

Dingguo Zhang; Qiuling Lin; Ruiyue Shi; Lisheng Wang; Jun Yao; Yanhui Tian

doi:10.1055/a-0625-6326

Endoscopy, Table of Contents

Endoscopy 2018; 50(12): 1180-1185
DOI: 10.1055/a-0625-6326

Innovations and brief communications

Ligation-assisted endoscopic submucosal resection with apical mucosal incision to treat gastric subepithelial tumors originating from the muscularis propria

Dingguo Zhang

¹Department of Gastroenterology, Shenzhen People’s Hospital, Second Clinical Medical College of Jinan University, Shenzhen, China

,

Qiuling Lin

²Department of General Practice, Shenzhen People’s Hospital, Second Clinical Medical College of Jinan University, Shenzhen, China

,

Ruiyue Shi

¹Department of Gastroenterology, Shenzhen People’s Hospital, Second Clinical Medical College of Jinan University, Shenzhen, China

,

Lisheng Wang

¹Department of Gastroenterology, Shenzhen People’s Hospital, Second Clinical Medical College of Jinan University, Shenzhen, China

,

Jun Yao

¹Department of Gastroenterology, Shenzhen People’s Hospital, Second Clinical Medical College of Jinan University, Shenzhen, China

,

Yanhui Tian

¹Department of Gastroenterology, Shenzhen People’s Hospital, Second Clinical Medical College of Jinan University, Shenzhen, China

› Author Affiliations

Abstract

Background This study aimed to evaluate the clinical efficacy, safety, and feasibility of performing endoscopic submucosal resection with a ligation device (ESMR-L) after apical mucosal incision (AMI) for the treatment of gastric subepithelial tumors originating from the muscularis propria (SET-MPs).

Methods 14 patients with gastric SET-MPs were treated by ESMR-L with AMI between December 2016 and May 2017. The complete resection rate, operation duration, and postoperative complications were collected. All patients were followed for 2 – 6 months.

Results The complete resection rate was 100 %, the mean tumor size was 10.71 ± 3.45 mm (7 – 18 mm), and the median operative time was 18.5 minutes. Perforation occurred in four patients, with all lesions being completely repaired endoscopically. No delayed bleeding or peritoneal signs were observed. No residual lesions or recurrence were found during the follow-up period.

Conclusions AMI with ESMR-L appears to be an efficient and simple method for the histological diagnosis of gastric SET-MPs, but it carries a high perforation rate and cannot guarantee cure.

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References

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