Current Status of Endoscopic Resection of Gastric Subepithelial Tumors

• Published in: The American journal of gastroenterology Vol. 114; no. 5; pp. 718 - 725
• Main Authors: Chen, Huimin, Li, Baiwen, Li, Lianyong, Vachaparambil, Cicily T., Lamm, Vladimir, Chu, Yuan, Xu, Meidong, Cai, Qiang
• Format: Journal Article
• Language: English
• Published: United States Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins 01.05.2019
• Subjects: Dissection; Early Detection of Cancer; Endoscopic Mucosal Resection - methods; Endoscopic Mucosal Resection - trends; Endoscopy; Gastric Mucosa - pathology; Gastric Mucosa - surgery; Health surveillance; Humans; Medical diagnosis; Precancerous Conditions - diagnosis; Precancerous Conditions - pathology; Precancerous Conditions - surgery; Stomach Neoplasms - diagnosis; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Tumors
• ISSN: 0002-9270; 1572-0241; 1572-0241
• DOI: 10.14309/ajg.0000000000000196

Most gastrointestinal (GI) subepithelial tumors (SETs) are identified incidentally during endoscopic examination and are located in the stomach. Some SETs are malignant or have the potential to become malignant. Tumors originating from deeper layers, such as the muscularis propria or serosa, are not easy to diagnose and resect. Current guidelines recommend yearly endoscopic surveillance of SETs smaller than 2 cm. This recommendation may not be cost-effective in managing GI SETs. Endoscopic resection results not only in obtaining sufficient tissue for pathological diagnosis but also in resection and curing the tumor. Many different endoscopic methods for resection of GI SETs have been published in the literature. To avoid confusion, we have divided these methods into standard endoscopic submucosal dissection, modified endoscopic submucosal dissection, submucosal tunneling endoscopic resection, and nonexposed and exposed endoscopic full-thickness resection. These procedures offer less invasive approaches than surgery for resection of GI SETs and may be the most cost-effective in taking care of patients with GI SETs.