Clinical value of preoperative mark for the submucosal tumor originating from the muscluaris prop- ria around the cardia in submucosal tunnel / 中华消化内镜杂志

Objective To evaluate the clinical value of preoperative mark with methylene blue for the submucosal tumor originating from the muscluaris propria around the cardia in submucosal tunnel.Meth-ods A total of 27 patients with cardiac tumors originating from muscularis propria diagnosed by endoscopy and endoscopic ultrasonography underwent endoscopic submucosal tunnel dissection from June 2011 to May 2014.Eighteen cases were marked by methylene blue,and 9 others were not.The operation time and the in-cidence of complications were compared between the two groups.Results All lesions were resected success-fully.The time of lesion location of non-mark group was 14.7 minutes(9-32 min),and that of mark group was 8.1 minutes(7-10 min).The incidence of subcutaneous emphysema of thorax and cervix of non-mark group was 2 /9(2 cases),and that of the mark group was 1 /18(1 case).The incidence of pneumoperitone-um of non-mark group was 1 /9(1 case),while that of the mark group was 2 /18(2 cases).There was no pneumothorax or mediastinal emphesema in all cases.Conclusion Marking with methylene blue before op-eration can shorten operation time effectively and lower incidence of complications.

Ligation-assisted endoscopic dissection: a novel technique for resection of small gastric tumors origihating from muscularis propria / 中华消化内镜杂志

Objective To evaluate the efficacy and safety of ligation-assisted endoscopic dissection (ED-L) technique for the removal of gastric tumors originating from muscularis propria.Methods A total of 33 patients with gastric tumors originating from muscularis propria less than 10 mm were treated with ED-L procedures.The tumor was ligated by elastic bands.Endoscopic dissection was performed until the tumor was partially or completely dissected from muscularis propria by using Hook knife and/or IT-knife.The wound was closed with metallic clips and medical adhesive.The patients were followed up 1 week,1 month,3 months,6 months and 12 months thereafter with endoscopy,respectively.Results Of the 33 gastric tumors,there were 25 partial dissections and 8 complete dissections.All of the tumors sloughed completely.Pathological diagnoses of all the patients were acquired.No complications like perforation occurred except for one self-limiting and non-life-threatening hemorrhage.There was no recurrent case during the 3-18 months of follow-up period.Conclusion ED-L is a safe,effective and relatively simple technique for excision of small gastrointestinal tumors originating from muscularis propria,providing a histopathological diagnosis as well.