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Objective To investigate endoscopic ultrasonography diagnosis and classification of gastric fundus-cardiac tumors originated from the muscularis propria. Methods One hundred and two patients with gastric fundus-cardiac submucosal tumors originated from the muscularis propria were diagnosed by endoscopic ultrasonography from Jan, 2011 to Jun, 2015. All patients were treated by endoscopy or surgery, and diagnosed by postoperative pathology and immunohistochemistry staining. These cases were analyzed retrospectively. Results The 102 patients with gastric fundus-cardiac tumors originated from the muscularis propria included 39 men and 63 women. Their ages were from 25-85 years old, average 56.22± 11.98 years. The tumor sizes were from 0.4 to 10.4cm, average 3.72± 2.18cm. The patients were diagnosed having leiomyoma in 81 and interstitialoma in 21 by preoperative endoscopic ultrasonography. Postoperative pathology and immunohistochemistry staining confirmed that leiomyoma was misdiagnosed as mesenchymoma in 5 patients. The misdiagnosis rate of endoscopic ultrasonography for gastric fundus-cardiac tumors originated from the muscularis propria was 4.9% (5/102). In leiomyomas, isolated nodular type was seen in 29 cases, earthworm type in 21, and multiple nodular type in 36. Conclusion Endoscopic ultrasonography is a safe effective important method for diagnosis and classification of gastric fundus-cardiac submucosal tumors originated from the muscularis propria.
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ObjectiveTo investigate the clinical value of endoscopic esophageal submucosal tunnel resection of gastric fundus-cardiac tumors originating from muscularis propria.Methods Clinical date of 18 patients with gastric fundus-cardiac submucosal tumors originating from muscularis propria who underwent endoscopic esophageal submucosal tunnel resection from January 2011 to December 2011 were retrospectively collected and analyzed.ResultsAll lesions were successfully and completely resected in 18 patients,with sizes ranging from 0.7 cm to 7.2 cm,mean (2.43 ± 1.91 ) cm.Pneumoretroperitoneum,pneumomediastinum and pneumohypoderma occured during the procedure in 2 cases,but spontaneously resolved in 3 days.Fever with increased WBC within 24 h after the procedure occurred in one patient,and was cured in two days with antibiotics.There were no severe complications including bleeding,perforation or death.All patients could have liquid diet 3 days later after the operation.Follow-up endoscopy at 1 week after the operation showed a healing of esophageal incision.ConclusionEndoscopic esophageal submucosal tunnel resection is a safe and effective method for gastric fundus-cardiac submucosal tumors originating from the muscularis propria,lessening the difficulty of traditional endoscopic resection.