Application of Endoscopic Submucosal Excavation Assisted With Ligation Device for Treatment of Gastrointestinal Submucosal Tumors / 胃肠病学

ABSTRACT

Background: There are a variety of endoscopic techniques for treatment of gastrointestinal submucosal tumors (SMTs). However, because of the difficulties in operation, high technique needs of operator and long period of training needed, some of these techniques could not be promoted and implemented in primary hospitals. Aims: To evaluate the feasibility and safety of endoscopic submucosal excavation assisted with ligation device (ESE-LD) for treatment of small gastrointestinal SMTs. Methods: The clinical data of 75 patients who underwent ESE-LD during January 2014 to July 2019 at the Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine and Jinling Hospital for treatment of small gastrointestinal SMTs (<2 cm in diameter) were retrospectively collected and analyzed. Results: In the 75 small gastrointestinal SMTs, 42 were originated from submucosa and 33 from muscularis propria. Eighteen lesions were located in esophagus, 30 in stomach, 6 in duodenum and 21 in colorectum. All tumors (mean diameter 13 mm±3 mm, range 0.5-2 cm) achieved en bloc resection. The mean time of ESE-LD procedure was (16.7±3.2) min, and the mean time of hospitalization was (5.08±1.21) d. No delayed bleeding and perforation requiring further intervention occurred. There were no recurrences during the follow-up period of (33.8±5.2) months. Conclusions: ESE-LD is safe and effective for treatment of gastrointestinal SMTs less than 2 cm in diameter. Moreover, it is easy to operate with short operation time. ESE-LD might be recommended to be promoted in primary hospitals.