Endoscopic submucosal dissection for the treatment of large gastric submucosal tumors originating from the muscularis propria layer: a single center study

Abstract

Background and Aims: This retrospective study was designed to evaluate the safety and efficacy of endoscopic submucosal dissection (ESD) for the resection of gastric submucosal tumors (SMTs) originating from the muscularis propria (MP) layer at our institution.

Patients and Methods: From January 2010 to January 2014, a total of 49 patients underwent ESD for the resection of MP-originating gastric SMTs. The characteristics of the 49patients, clinical efficacy, safety of ESD, and post-ESD pathological diagnoses were evaluated retrospectively.

Results: ESD was successfully performed in 48 cases, and one case was converted to surgery. Pathological diagnosis included 43 gastrointestinal stromal tumors, 5 leiomyomas, and 1 schwannoma. During the procedure, 9 patients developed perforation. These patients recovered after conservative treatment. No residual or recurrent tumors were detected during the follow-up period.

Conclusions: ESD seems to be a feasible, safe, effective and minimally invasive procedure, even for the resection of large gastric tumors originating from the MP. However, more studies should be carried out in the future.

Zusammenfassung

Hintergrund und Ziele: Diese retrospektive Studie wurde entwickelt, um in unserer Einrichtung die Sicherheit und Effizienz der endoskopischen Submukosadissektion (ESD) zur Resektion von submukösen Magentumoren (SMTs), ausgehend von der Muscularis propria, zu evaluieren.

Patienten und Methoden: Von Januar 2010 bis Januar 2014 wurde bei insgesamt 49 Patienten eine ESD zur Resektion von SMTs, ausgehend von der Muscularis propria, durchgeführt. Die Auswertung der Daten der 49 Patienten, der klinischen Effizienz, der Sicherheit der ESD und der pathologischen Diagnosen nach Durchführung der ESD erfolgte retrospektiv.

Ergebnisse: In 48 Fällen wurde eine ESD erfolgreich durchgeführt, in einem Fall wurde eine Operation notwendig. Die pathologische Diagnose umfasste 43 gastrointestinale Stromatumoren, 5 Leiomyome und 1 Schwannom. Während des Eingriffs kam es bei 9 Patienten zu einer Perforation. Diese Patienten erholten sich nach konservativer Behandlung. Während des Nachbehandlungszeitraums wurden keine Tumorresiduen oder Rezidive diagnostiziert.

Schlussfolgerung: Die ESD scheint eine geeignete, sichere, effiziente und minimalinvasive Technik zu sein, auch für die Resektion von großen, von der Muscularis propria ausgehenden Magentumoren. In der Zukunft sind jedoch weitere Studien erforderlich.

Schlüsselwörter

endoskopische Submukosadissektion - submuköse Tumoren - Muscularis propria

Key words

endoscopic submucosal dissection - submucosal tumors - muscularis propria

^* F. Meng and Z. Zhang contributed equally to this manuscript.

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