Endoscopic band ligation of small gastric stromal tumors and follow-up by endoscopic ultrasonography

• Published in: Surgical endoscopy Vol. 21; no. 4; pp. 574 - 578
• Main Authors: Sun, Siyu, Ge, Nan, Wang, Caixia, Wang, Mengchun, Lü, Qingjie
• Format: Journal Article
• Language: English
• Published: New York, NY Springer 01.04.2007; Springer Nature B.V
• Subjects: Adult; Aged; Biological and medical sciences; Biopsy; Biopsy, Needle; Digestive system. Abdomen; Endoscopy; Endosonography; Female; Follow-Up Studies; Gastroenterology. Liver. Pancreas. Abdomen; Gastrointestinal cancer; Gastrointestinal Stromal Tumors - diagnostic imaging; Gastrointestinal Stromal Tumors - pathology; Gastrointestinal Stromal Tumors - surgery; Gastroscopy - adverse effects; Gastroscopy - methods; General aspects; Humans; Immunohistochemistry; Investigative techniques, diagnostic techniques (general aspects); Ligation - methods; Male; Medical sciences; Middle Aged; Neoplasm Staging; Postoperative Care; Prospective Studies; Risk Assessment; Stomach Neoplasms - diagnostic imaging; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Survival Rate; Treatment Outcome; Tumors; Ulcers; Ultrasonic imaging; Liaoning China; China; Sonography; Therapy; Endoscopic route; Endoscopic ultrasonography; Malignant tumor; Hemorrhage; Endoscope; Gastrointestinal stromal tumor; Clip; Medicine; Treatment; Biopsy; Echography; Digestive diseases; Submucosa; Endoscopy; Followup; Gastric tumor; Cicatrization; Gastric disease
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-006-9028-4

Gastrointestinal stromal tumor (GIST) is a relatively common gastric submucosal tumor with potential for malignant transformation. The efficacy of a new method for resection of these tumors, endoscopic band ligation, was evaluated. The study included 29 patients with small gastric stromal tumors arising in the gastric muscularis propria as determined by endoscopy, endoscopic ultrasonography (EUS), and deep endoscopic biopsies. A standard endoscope with a transparent cap attached to the tip was used. The cap was placed over the lesion, maximum sustained suction was applied, and an elastic band was released around the base. Beginning two weeks after banding, the lesions were observed endoscopically once per week until healing was complete. Thereafter, all patients underwent EUS every two to three months on schedule. The 28 GISTs sloughed completely. The mean time required for complete healing after band ligation was 4.8 weeks. One lesion did not slough because they were not completely ligated. The lesion was ligated for the second time and sloughed completely. Bleeding occurred in one patient three days after ligation because the lesion sloughed early. The bleeding was managed successfully with metallic clips. No perforation and other complications occurred. Followup ranged from 36 to 51 months, during which time only one recurrence was observed four months postoperatively. Endoscopic band ligation with systematic followup by EUS is an effective and safe treatment for small GISTs.