Endoscopic muscularis dissection for upper gastrointestinal subepithelial tumors originating from the muscularis propria

Liu, Bing-Rong; Song, Ji‐Tao; Qü, Bo; Wen, Jifeng; Jia, Yin; Liu, Wei

doi:10.1007/s00464-012-2305-5

Cited by 87 publications

(59 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Strengths of our study included its relative large size (considering the low incidence of esophageal/cardial SMTs and the study size of other published literatures), relative long period of Follow-up (since 2010), subgroup analysis based on tumor size, and that potential bias was reduced in several ways. Although this was a one-center retrospective study, our therapeutic results were in accordance with the published literatures [4,5,7,8,11,12,17] ); slight difference in complete resection rate, perforation rate, and operation time can be largely explained by limited study size (31 at most [4] ). Time bias did exist as endoscopist had gotten better and better as time went on.…”

Section: Discussionsupporting

confidence: 92%

“…CO2 insufflation was used in all procedures. ESE and STER procedures have been reported in various literatures [3][4][5][6][7][8][9][10][11][12]; here, we briefly described the key steps illustrated by endoscopic images.…”

Section: Procedures Of Ese and Stermentioning

confidence: 98%

“…Endoscopic submucosal excavation (ESE) and submucosal tunneling endoscopic resection (STER) provide definitive histological diagnosis as well as therapeutic approaches for GI submucosal tumors (SMTs) arising from muscularis propria (MP), which used to be a diagnostic dilemma [2]. While ESE is basically a technical extension of ESD-just excavating deeper into MP [3][4][5][6][7]; STER uses a submucosal tunnel as an operating space to resect targeted tumor. This recently rising tunneling technique possesses an obvious advantage of preserving the integrity of covering mucosa as a barrier against air/ liquid leakage.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Endoscopic resection of submucosal tumors in muscularis propria: the choice between direct excavation and tunneling resection

et al. 2014

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Procedures Of Ese and Stermentioning

confidence: 98%

mentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic resection of submucosal tumors in muscularis propria: the choice between direct excavation and tunneling resection

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Transluminal endoscopic resection techniques have been described for small GISTs [51,52,53]. Since GISTs arise from the muscularis propria layer, established endoscopic resection techniques in the upper gastrointestinal tract (endoscopic mucosal resection, endoscopic submucosal dissection) can be expected to be associated with an increased risk of incomplete resection.…”

Section: Management Of Localized Gistsmentioning

confidence: 99%

State of the Art in the Treatment of Gastrointestinal Stromal Tumors

Garlipp

Bruns

2014

Gastrointest Tumors

View full text Add to dashboard Cite

Background: Gastrointestinal stromal tumors (GISTs) are the most frequently diagnosed mesenchymal neoplasms of the gastrointestinal tract. Despite their biological and clinical heterogeneity, the majority of these tumors are positive for the receptor tyrosine kinase KIT and are driven by KIT- or platelet-derived growth factor receptor alpha (PDGFRA)-activating mutations. There are still uncertainties regarding their clinical and molecular characterization and the optimal treatment regimens, making it difficult to establish a universal treatment algorithm for these tumors. Summary: From a clinical perspective, the main difference between GISTs and other gastrointestinal neoplasms is that the benign or malignant behavior of GISTs cannot be predicted from histopathology, but instead relies on empirically established scoring systems. Clinical data suggest that malignant potential may be an inherent quality of some GISTs rather than a feature acquired by the tumor during disease progression. Thus, some patients may require prolonged anti-tumor treatment even after complete surgical removal of the tumor. Key Message: Although GISTs are the most frequently occurring mesenchymal neoplasms in the gastrointestinal tract, no universal treatment algorithms exist. This paper reviews the current evidence that guides the management of GISTs. Practical Implications: The management of localized GISTs involves the use of surgical resection, with the inclusion of preoperative tyrosine kinase inhibitor treatment for locally advanced, primarily unresectable tumors and for resectable cases requiring extensive surgery. Imatinib is also indicated as adjuvant therapy after complete surgical removal of GISTs with a high estimated risk of recurrence unless specific mutations conferring imatinib resistance are present. The optimal duration of adjuvant treatment is still controversial. For patients with metastatic imatinib-sensitive GISTs, imatinib constitutes the first-line standard treatment. Molecular characterization of the tumor (with respect to the PDGFRA and KIT genes) is mandatory prior to imatinib therapy. Sunitinib and regorafenib are established as alternative treatments for patients demonstrating generalized disease progression on imatinib. New tyrosine kinase inhibitors such as ponatinib and crenolanib as well as drugs targeting alternative pathways are currently under investigation. Surgery and locally ablative treatments may be indicated in some metastatic patients.

show abstract

“…In contrast, both occurred with a dissection of submucosal tumors, with one of these invading the muscularis propria. It is known that dissection of submucosal tumors and dissection in the muscularis propria have a higher rate of perforation (18). In such cases, instead of categorizing a perforation as a complication, it may instead be considered a calculated peroperative incident-as in traditional surgery-or an endoscopic full-thickness resection (19).…”

Section: Discussionmentioning

confidence: 99%

Implementation of Endoscopic Submucosal Dissection for Gastric Lesions in Norway

Rushfeldt

Aabakken

2015

Scand J Surg

View full text Add to dashboard Cite

Background and aims: endoscopic submucosal dissection is a minimal invasive method for an en bloc resection of dysplasia or early cancer in the stomach. It was developed in Japan in the 1990s, but thus far has not been widely adopted in western countries. the aim of this study is to report from the introductory phase of gastric endoscopic submucosal dissection in a small-volume scandinavian center.Material and Methods: the 15 first patients operated on with endoscopic submucosal dissection in the stomach at the university Hospital of north norway were consecutively registered in a prospective database and evaluated as a quality assurance study. the indications for the procedures were diagnostic or therapeutic.Results: three patients had benign lesions, three had low-grade dysplasia, five had high-grade dysplasia, two had neuroendocrine tumors, and two had early gastric cancers (t1b). the r0 resection rate was 83%. one neuroendocrine tumor was directed to surgery. no recurrences have been detected after the median of 6 months, and with the exception of one delayed bleeding being treated endoscopically, no serious complications occurred. two perforations were perioperatively closed with clips.Conclusion: this is the first report on gastric endoscopic submucosal dissection in scandinavia. preliminary results from an introductory phase indicate that endoscopic submucosal dissection for dysplasia or early gastric cancer may be conducted safely and with acceptable results even in a small-volume center, assuming that surgeons and gastroenterologists in a region direct cases to one individual who can learn this skill.

show abstract

Endoscopic muscularis dissection for upper gastrointestinal subepithelial tumors originating from the muscularis propria

Cited by 87 publications

References 27 publications

Endoscopic resection of submucosal tumors in muscularis propria: the choice between direct excavation and tunneling resection

Endoscopic resection of submucosal tumors in muscularis propria: the choice between direct excavation and tunneling resection

State of the Art in the Treatment of Gastrointestinal Stromal Tumors

Implementation of Endoscopic Submucosal Dissection for Gastric Lesions in Norway

Contact Info

Product

Resources

About