Endoscopic submucosal dissection for gastrointestinal stromal tumors: a report of 20 cases / 中华胃肠外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for the removal of small gastrointestinal stromal tumor (GIST).</p><p><b>METHODS</b>GIST diagnosed by endoscopic ultrasonography (EUS) was managed by ESD with the needle knife as follows(1)Injecting normal saline into the submucosa. (2)Pre-cutting the surrounding mucosa of the lesion. (3) Dissecting the submucosal tissue to display GIST and resecting the lesion completely.</p><p><b>RESULTS</b>Of 20 GISTs, 12 located in gastric fundus, and 1 in gastric antrum, 3 in gastric body and 4 in rectum. Lesion diameter ranged from 0.5 to 3.2 cm and the mean resected size was 1.6 cm. Among 20 lesions, 19 were resected with ESD completely, and 1 received additional operation because of tumor residual in the wound after ESD. The success rate of ESD was 95.0% (19/20). The mean ESD procedure time was 87.5 min (ranging from 60 to 150 min). None of the patients had delayed bleeding after ESD. Perforations occurred in 3 cases after the dissection of the GIST, which were closed with metallic endoclips without additional surgical suture. The perforation rate of ESD was 15.0% (3/20). The follow up ranged from 2 to 12 months, and no recurrence was observed by EUS except the above-mentioned case undergone additional operation.</p><p><b>CONCLUSION</b>ESD is effective and safe for small GIST, which can resect the whole lesion and provide pathological information.</p>