In:
GE - Portuguese Journal of Gastroenterology, S. Karger AG
Abstract:
〈 b 〉 〈 i 〉 Background/Aims: 〈 /i 〉 〈 /b 〉 Endoscopic submucosal dissection (ESD) has been proposed for removal of gastrointestinal subepithelial tumors (GI-SETs), but data are still scanty. This study aimed to report a case series from a western country. 〈 b 〉 〈 i 〉 Patients and Methods: 〈 /i 〉 〈 /b 〉 Data of patients with upper GI-SETs suitable for ESD removal observed in 4 centers were retrospectively reviewed. Before endoscopic procedure, the lesion was characterized by endosonographic evaluation, histology, and CT scan. The 〈 i 〉 en bloc 〈 /i 〉 resection and the R0 resection rates were calculated, as well as incidence of complications, and the 1-year follow-up was reported. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Data of 84 patients with esophageal ( 〈 i 〉 N 〈 /i 〉 = 13), gastric ( 〈 i 〉 N 〈 /i 〉 = 61), and duodenal ( 〈 i 〉 N 〈 /i 〉 = 10) GI-SETs were collected. The mean diameter of lesions was 26 mm (range: 12–110 mm). There were 17 gastrointestinal stromal tumors, 12 neuroendocrine tumors, 35 leiomyomas, 18 lipomas, and 2 hamartomas. 〈 i 〉 En bloc 〈 /i 〉 and R0 resection were achieved in 83 (98.8%) and in 80 (95.2%) patients, respectively. Overall, a complication occurred in 11 (13.1%) patients, including bleeding ( 〈 i 〉 N 〈 /i 〉 = 7) and perforation ( 〈 i 〉 N 〈 /i 〉 = 4). Endoscopic approach was successful in all bleedings, but 1 patient who required radiological embolization, and in 2 perforations, while surgery was performed in the other patients. Overall, a surgical approach was eventually needed in 5 (5.9%), including 3 in whom R0 resection failed and 2 with perforation. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Our study found that ESD may be an effective and safe alternative to surgical intervention for both benign and localized malignant GI-SETs.
Type of Medium:
Online Resource
ISSN:
2341-4545
,
2387-1954
Language:
English
Publisher:
S. Karger AG
Publication Date:
2022
detail.hit.zdb_id:
2835774-7
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