Endoscopic enucleation of upper-GI submucosal tumors by using an insulated-tip electrosurgical knife

Park, Young Soo; Park, Seung Woo; Kim, Taeil; Song, Si Young; Choi, Eric H.; Chung, Jae Bock; Kang, Jin Kyung

doi:10.1016/s0016-5107(03)02717-2

Cited by 133 publications

(102 citation statements)

References 10 publications

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“…FNA in our series was able to confirm GIST only in 2 of 8 cases without the evaluation of the mitotic index. The high success rate (90 % in our series) achieved with ESD and the absence of relevant complications suggest this procedure as a diagnostic and in some case therapeutic option in the resection of SMTs [15][16][17][18][19]. The main limitation of this study was that patients were assigned to ESD based solely on the patient's attitude.…”

Section: Discussionmentioning

confidence: 83%

Endoscopic submucosal dissection in the treatment of gastric submucosal tumors: results from a retrospective cohort study

et al. 2012

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Background A submucosal tumor (SMT) of the stomach, which is an occasional finding during routine upper gastrointestinal endoscopy, may pose diagnostic and therapeutic challenges. Methods To assess whether endoscopic submucosal dissection (ESD) is a feasible approach to definitively cure SMTs, the authors performed a retrospective cohort study with two endoscopic italian centers.Results The study consisted of 20 patients with SMTs who underwent ESD. The patients underwent ESD and were followed up by endoscopy. We analyzed complete resection rate, frequency of complications, and survival. The overall rate of R0 resection was 90 % (18/20), with two endoscopic failures, one for a submucosal tumor and one for a neoplasm deeply infiltrating the proper muscle layer. The median procedure time was 119.1 min (range 40-240 min). The median size of the resected specimens was 29 mm (range 15-60 mm). Perforation occurred in 3 patients; all were treated conservatively. There were no cases of severe bleeding. Based on histopathological findings, 6 cases of ectopic pancreas, 1 of ectopic spleen, 3 of leiomyoma, and 10 of gastrointestinal stromal tumor (GIST) were diagnosed. Complete resection was obtained in all GIST cases. Among the 10 GIST cases treated by ESD, no death occurred: the 5-year disease-specific survival rate was 100 %. Conclusions The high success rate of 90 % and the low incidence of complications should indicate ESD is the correct diagnostic and definitive treatment in selected patients.

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Section: Discussionmentioning

confidence: 83%

Endoscopic submucosal dissection in the treatment of gastric submucosal tumors: results from a retrospective cohort study

et al. 2012

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“…With the recent advent of endoscopic resection techniques, endoscopists can now remove mucosal or submucosal tumors by endoscopic mucosal resection (EMR). Complete resection of subepithelial tumors larger than 2 cm in size and those originating from the muscularis propria layer still remain difficult by EMR [30][31][32] . A study performed in elderly and high risk surgical patients showed that EUS guided band ligation of small duodenal tumors is a safe and efficient therapeutic method [33] .…”

Section: Management Of Gistmentioning

confidence: 99%

A gist of gastrointestinal stromal tumors: A review

Rammohan¹,

Sathyanesan²,

Rajendran³

et al. 2012

WJGO

156

193

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enchymal tumors. Both traditional and minimally invasive surgery are used to remove these tumors with minimal morbidity and excellent perioperative outcomes. The revolutionary use of specific, molecularlytargeted therapies, such as imatinib mesylate, reduces the frequency of disease recurrence when used as an adjuvant following complete resection. Neoadjuvant treatment with these agents appears to stabilize disease in the majority of patients and may reduce the extent of surgical resection required for subsequent complete tumor removal. The important interplay between the molecular genetics of GIST and responses to targeted therapeutics serves as a model for the study of targeted therapies in other solid tumors. This review summarizes our current knowledge and recent advances regarding the histogenesis, pathology, molecular biology, the basis for the novel targeted cancer therapy and current evidence based management of these unique tumors. AbstractGastrointestinal stromal tumors (GISTs)

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“…Usually, this incision is made to separate a lesion from surrounding normal mucosa during endoscopic submucosal dissection or to expose a submucosal tumor. 13 However, in the described case, it was used (after obtaining patient consent) to perform mucosal incision to expose the embedded toothpick. Successful removal of the remnant, avoided laparoscopic surgery, and the patient recovered rapidly.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Removal of a Toothpick Impacted in the Stomach Wall by Mucosal Incision

Han

Bang

Kim

et al. 2012

Korean J Helicobacter Up Gastrointest Res

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Toothpicks are not uncommonly swallowed, and subsequently, may be impacted into gastrointestinal wall and cause morbidities, and even mortality. Therefore, the early diagnosis and immediate retrieval of an ingested toothpick is important. In many cases, endoscopic removal is attempted initially, but if this fails or a complication is encountered, surgery should be considered. The authors experienced a case of ingested toothpick penetrating the gastric wall. A 51-year-old woman visited our hospital with epigastric pain of one-week duration. Upper endoscopy revealed that the sharp end of a toothpick had been impacted into the distal antrum. Endoscopic removal using an alligator jaw forceps failed because the toothpick broke during removal and our continued attempts to extract the remnant resulted in it becoming more embedded in the stomach wall. In such circumstances, surgical treatment should be considered. However, we incised the mucosa to expose the remnant toothpick, and fortunately, we were then able to grasp and remove the toothpick using an alligator jaw forceps. We report this unusual case of a toothpick impacted in the gastric wall that was resolved endoscopically by mucosal incision. (Korean J Helicobacter Up Gastrointest Res 2012;12:276-279)

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Endoscopic enucleation of upper-GI submucosal tumors by using an insulated-tip electrosurgical knife

Cited by 133 publications

References 10 publications

Endoscopic submucosal dissection in the treatment of gastric submucosal tumors: results from a retrospective cohort study

Endoscopic submucosal dissection in the treatment of gastric submucosal tumors: results from a retrospective cohort study

A gist of gastrointestinal stromal tumors: A review

Endoscopic Removal of a Toothpick Impacted in the Stomach Wall by Mucosal Incision

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