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CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(04): E347-E354
DOI: 10.1055/a-1783-8675
Original article

Efficiency of an endoscopic resection strategy for management of submucosal tumors < 20 mm in the upper gastrointestinal tract

Fabrice Caillol
1   Endoscopy Department, Paoli Calmettes Institute, Marseille, France
,
Elise Meunier
1   Endoscopy Department, Paoli Calmettes Institute, Marseille, France
,
Christophe Zemmour
2   Statistics Department, Paoli Calmettes Institute, Marseille, France
,
Jean-Philippe Ratone
1   Endoscopy Department, Paoli Calmettes Institute, Marseille, France
,
Jerome Guiramand
3   Surgery Department, Paoli Calmettes Institute, Marseille, France
,
Solene Hoibian
1   Endoscopy Department, Paoli Calmettes Institute, Marseille, France
,
Yanis Dahel
1   Endoscopy Department, Paoli Calmettes Institute, Marseille, France
,
Flora Poizat
4   Pathology Department, Paoli Calmettes Institute, Marseille, France
,
Marc Giovannini
1   Endoscopy Department, Paoli Calmettes Institute, Marseille, France
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Erratum zu diesem Artikel:

Correction: Efficiency of an endoscopic resection strategy in the management of submucosal tumors less than 20 mm in size and located in the upper gastrointestinaEndosc Int Open 2022; 10(04): C4-C4
DOI: 10.1055/a-1828-5001

Abstract

Background and study aims The histologic diagnosis of submucosal tumors (SMTs) < 20 mm is challenging. Monitoring is the main option offered, but compliance is debatable. Endoscopic resection (ER) of malignant SMTs or those with an uncertain diagnosis is an alternative that has already been reported about and proposed in our center. The aims of this study were to confirm the safety of this resection strategy and to perform long-term follow-up of malignant SMTs after resection.

Patients and methods All patients who underwent ER for SMTs < 2 cm in a single center between 2007 and 2019 were included retrospectively. Patients were classified into two groups according to the need for postresection follow-up: benign SMTs (B-SMTs) and follow-up SMTs (FU-SMTs).

Results One hundred and one patients were included. The mean tumor size was 16.7 mm. In total, 92 of 101 SMTs had an uncertain diagnosis. Macroscopic resection was completed for 95 SMTs (93.1 %), with en bloc resection in 94 (92.1%). The morbidity rate was 3 %, with no mortality. A total of 84 of 101 SMTs (84 %) were B-SMTs and did not need monitoring, and 17 SMTs (19.7 %) were FU-SMTs (8 gastrointestinal stromal tumors, 6 neuroendocrine tumors, and 3 others). No relapse was reported in the FU-SMT group, with a median follow-up duration of 33 months [4–127] (61 months [17–127] for the gastrointestinal stroma tumor group).

Conclusions The study results suggest ER is a potentially reliable and effective strategy for upper gastrointestinal tract SMTs < 20 mm. Although the strategy needs further validation in advanced care units, it could eliminate the need for long-term monitoring, therefore targeting such follow-up efforts to patients with FU-SMTs.



Publikationsverlauf

Eingereicht: 22. April 2021

Angenommen nach Revision: 21. September 2021

Artikel online veröffentlicht:
14. April 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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