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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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Objective To investigate clinical effect of combined laparoscopic and endoscopic submucosal resection for the gastric antrum-body tumors originated from the muscularis propria.Methods A total of 8 patients with gastric antrum-body tumors originated from the muscularis propria were treated by combined laparoscopic and endoscopic submucosal resection from Jan 2013 to Apr 2014.All patients were diagnosed as having gastric antrum-body tumors originated from the muscularis propria by preoperative endoscopic ultrasonography.Endoscopy showed that the surface mucosa of tumors were normal in all patients.Tumors were found in the gastric antrum-body front wall in 4 cases,and in the back wall in 2 cases,and in the lesser omental bursa in 1 case,and in the greater omental bursa in 1 case.The tumors size was from 1.5 to 3.5 cm,averaging (2.4 ± 0.7) cm.The therapeutic procedure included three phases.The lesion was first exposed with laparoscopy.Then,the fluid was injected into the submucosa in the part of tumor by endoscopy.Finally the tumor was resected by laparoscopy.These patients were followed up and analyzed retrospectively.Results Combined laparoscopic and endoscopic submucosal resection was successfully performed in all patients.All tumors were resected completely.Sever bleeding,infection or death were not found in any patients.Postoperative pathology and immunohistochemistry staining confirmed 6 stromal tumors and 2 neurofibroma.All patients were followed up for 6 months,and there was no recurrent case.Gastric mucosa and function were normal in all patients.Conclusion Combined laparoscopic and endoscopic submucosal resection is a simple,safe and effective method for gastric antrum-body tumors originated from the muscularis propria,and leads to little complication.
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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.