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Endoscopic submucosal dissection of large gastrointestinal stromal tumors in the esophagus and stomach
Author(s) -
He Zhankun,
Sun Chao,
Zheng Zhongqing,
Yu Qingxiang,
Wang Tao,
Chen Xin,
Cao Hailong,
Liu Wentian,
Wang Bangmao
Publication year - 2013
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12056
Subject(s) - medicine , gist , esophagus , stomach , perforation , argon plasma coagulation , endoscopic submucosal dissection , surgery , endoscopy , retrospective cohort study , endoscopic mucosal resection , gastroenterology , stromal cell , metallurgy , materials science , punching
Background and Aim Gastrointestinal stromal tumors ( GIST s), the most common mesenchymal tumors of the digestive tract with potential for malignant transformation, are mainly treated by open surgery or laparoscopic resection. The aim of this retrospective study was to evaluate the clinical efficacy, safety, and feasibility of endoscopic submucosal dissection ( ESD ) for large‐size (2–5 cm) GIST s in the esophagus and stomach. Methods A total of 31 patients with large‐size GIST s in the esophagus (6 patients) and stomach (25 patients) underwent ESD between S eptember 2008 and D ecember 2011. Demographics, clinical data, therapeutic outcomes, complications, pathological characteristics, risk classification, and follow‐up outcomes were recorded. Results ESD was successfully performed in 31 patients at age of 59.06 ± 7.23 years (range: 46–74). The mean time of the procedure was 70.16 ± 16.25 min (range: 40–105). Perforation for 2–10 mm occurred in six patients (19.35%) and was endoscopically repaired with clips or nylon bands, with no conversions to open surgery. Intraoperative bleeding occurred in three patients (9.68%) and was corrected with argon plasma coagulation or hot biopsy forceps. No mortalities occurred. The mean size of the resected tumors was 2.70 ± 0.72 cm (range: 2.0–5.0). Out of the 31 patients, 24 (77.42%) were at very low risk and 7 (22.58%) were at low risk. Positive rate of CD 117, DOG ‐1, and CD 34 were 83.87%, 12.90%, and 100%, respectively. A follow up for 14.29 ± 8.99 months (range: 3–39) showed no recurrence or metastasis. Conclusions ESD appears to be an effective, safe, and feasible treatment for large‐size GIST s in the esophagus and stomach.