ENDOSCOPIC SUBMUCOSAL DISSECTION FOR GASTRIC SUBMUCOSAL TUMOR, ENDOSCOPIC SUB-TUMORAL DISSECTION

Gastric submucosal tumor (SMT) is frequently found during screening endoscopy, but definitive diagnosis based on histological confirmation is relatively difficult. Even without accurate diagnosis before treatment, open or laparoscopic surgery is currently carried out to remove SMT. The purpose of th...

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Published inDigestive endoscopy Vol. 21; no. 4; pp. 266 - 269
Main Authors Hoteya, Shu, Iizuka, Toshiro, Kikuchi, Daisuke, Yahagi, Naohisa
Format Journal Article
LanguageEnglish
Published Melbourne, Australia Blackwell Publishing Asia 01.10.2009
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ISSN0915-5635
1443-1661
1443-1661
DOI10.1111/j.1443-1661.2009.00905.x

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Abstract Gastric submucosal tumor (SMT) is frequently found during screening endoscopy, but definitive diagnosis based on histological confirmation is relatively difficult. Even without accurate diagnosis before treatment, open or laparoscopic surgery is currently carried out to remove SMT. The purpose of this study was to demonstrate the feasibility of endoscopic submucosal dissection (ESD) in diagnostic treatment for submucosal tumor (SMT) of the stomach. Subjects in this case study comprised nine patients who had undergone ESD for gastric SMT. Before treatment, endoscopic ultrasonography was carried out in all cases to evaluate depth and origin of the SMT. Then ESD was only indicated for tumors of submucosal layer or muscularis mucosa origin. Using an endoscopic sub‐tumoral dissection technique with a hook knife and a flex knife, local complete resections were achieved in all patients without severe complications. These results suggest the clinical benefits of ESD avoiding oversurgery for the diagnostic treatment of gastric SMT of the submucosal layer and muscularis mucosa origin.
AbstractList Gastric submucosal tumor (SMT) is frequently found during screening endoscopy, but definitive diagnosis based on histological confirmation is relatively difficult. Even without accurate diagnosis before treatment, open or laparoscopic surgery is currently carried out to remove SMT. The purpose of this study was to demonstrate the feasibility of endoscopic submucosal dissection (ESD) in diagnostic treatment for submucosal tumor (SMT) of the stomach. Subjects in this case study comprised nine patients who had undergone ESD for gastric SMT. Before treatment, endoscopic ultrasonography was carried out in all cases to evaluate depth and origin of the SMT. Then ESD was only indicated for tumors of submucosal layer or muscularis mucosa origin. Using an endoscopic sub-tumoral dissection technique with a hook knife and a flex knife, local complete resections were achieved in all patients without severe complications. These results suggest the clinical benefits of ESD avoiding oversurgery for the diagnostic treatment of gastric SMT of the submucosal layer and muscularis mucosa origin.
Gastric submucosal tumor (SMT) is frequently found during screening endoscopy, but definitive diagnosis based on histological confirmation is relatively difficult. Even without accurate diagnosis before treatment, open or laparoscopic surgery is currently carried out to remove SMT. The purpose of this study was to demonstrate the feasibility of endoscopic submucosal dissection (ESD) in diagnostic treatment for submucosal tumor (SMT) of the stomach. Subjects in this case study comprised nine patients who had undergone ESD for gastric SMT. Before treatment, endoscopic ultrasonography was carried out in all cases to evaluate depth and origin of the SMT. Then ESD was only indicated for tumors of submucosal layer or muscularis mucosa origin. Using an endoscopic sub-tumoral dissection technique with a hook knife and a flex knife, local complete resections were achieved in all patients without severe complications. These results suggest the clinical benefits of ESD avoiding oversurgery for the diagnostic treatment of gastric SMT of the submucosal layer and muscularis mucosa origin.Gastric submucosal tumor (SMT) is frequently found during screening endoscopy, but definitive diagnosis based on histological confirmation is relatively difficult. Even without accurate diagnosis before treatment, open or laparoscopic surgery is currently carried out to remove SMT. The purpose of this study was to demonstrate the feasibility of endoscopic submucosal dissection (ESD) in diagnostic treatment for submucosal tumor (SMT) of the stomach. Subjects in this case study comprised nine patients who had undergone ESD for gastric SMT. Before treatment, endoscopic ultrasonography was carried out in all cases to evaluate depth and origin of the SMT. Then ESD was only indicated for tumors of submucosal layer or muscularis mucosa origin. Using an endoscopic sub-tumoral dissection technique with a hook knife and a flex knife, local complete resections were achieved in all patients without severe complications. These results suggest the clinical benefits of ESD avoiding oversurgery for the diagnostic treatment of gastric SMT of the submucosal layer and muscularis mucosa origin.
Author Iizuka, Toshiro
Hoteya, Shu
Yahagi, Naohisa
Kikuchi, Daisuke
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  surname: Hoteya
  fullname: Hoteya, Shu
  organization: Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
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  givenname: Toshiro
  surname: Iizuka
  fullname: Iizuka, Toshiro
  organization: Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
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  givenname: Daisuke
  surname: Kikuchi
  fullname: Kikuchi, Daisuke
  organization: Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
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  givenname: Naohisa
  surname: Yahagi
  fullname: Yahagi, Naohisa
  organization: Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
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References_xml – reference: Okabe H, Kanou T. Usefulness of a new histologic diagnostic method 'boring biopsy' in gastrointestinal submucosal tumors. Gastroenterol. Endosc. 1990; 32: 2740-1. (in Japanese with English abstract.)
– reference: Yamamoto H, Kawata H, Sunada K et al. Successful en-bloc resection of large superficial tumors in the stomach and colon using sodium hyaluronate and small-caliber-tip transparent hood. Endoscopy 2003; 35: 690-4.
– reference: Yahagi N, Fujishiro M, Kakushima N, Omata M. Endoscopic submucosal dissection for early gastric cancer using the tip of an electrosurgical snare (thin type). Dig. Endosc. 2004; 16: 34-8.
– reference: Kojima T, Takahashi H, Parra-Blanco A, Kohsen K, Fujita R. Diagnosis of submucosal tumor of the upper GI tract by endoscopic resection. Gastrointest. Endosc. 1999; 50: 516-22.
– reference: Oyama T, Tomori A, Hotta K et al. Endoscopic submucosal dissection of early esophageal cancer. Clin. Gastroenterol. Hepatol. 2005; 3: S67-70.
– reference: Ohkuwa M, Hosokawa K, Boku N, Ohtu A, Tajiri H, Yoshida S. New endoscopic treatment for intramucosal gastric tumors using an insulated-tip diathermic knife. Endoscopy 2001; 33: 221-6.
– reference: Soetikno RM, Gotoda T, Nakanishi Y et al. Endoscopic mucosal resection. Gastrointest. Endosc. 2003; 57: 567-79.
– reference: Eguchi T, Gotoda T, Oda I et al. Is endoscopic one-piece mucosal resection essential for early gastric cancer? Dig. Endosc. 2003; 15: 113-16.
– reference: Hosokawa K, Yoshida S. Recent advances in endoscopic mucosal resection for early gastric cancer. Gan To Kagaku Ryoho 1998; 25: 476-83. (in Japanese with English abstract.)
– reference: Gotoda T. A large endoscopic resection by endoscopic submucosal dissection procedure for early gastric cancer. Clin. Gastroenterol. Hepatol. 2005; 3: S71-73.
– reference: Park YS, Park SW, Kim TI et al. Endoscopic enucleation of upper-GI submucosal tumors by using an insulated-tip electrosurgical knife. Gastrointest. Endosc. 2004; 59: 409-15.
– reference: Walsh RM, Heniford BT. Laparoendoscopic treatment of gastric stromal tumors. Semin. Laparosc. Surg. 2001; 8: 189-94.
– reference: Yahagi N, Fujishiro M, Kakushima N et al. Merits and demerits of endoscopic submucosal dissection using a Flex knife. I to Cho. 2004; 39: 39-43. (in Japanese with English abstract.)
– reference: Uedo N, Iishi H, Tatsuta M et al. Longterm outcomes after endoscopic mucosal resection for early gastric cancer. Gastric. Cancer 2006; 9: 88-92.
– reference: Kawamoto K, Yamada Y, Furukawa N et al. Endoscopic submucosal tumorectomy for gastrointestinal submucosal tumors restricted to the submucosa: A new form of endoscopic minimal surgery. Gastrointest. Endosc. 1997; 46: 311-17.
– reference: Asaki S, Ishii N, Nishimura T, Ohara S, Yamaguchi N, Tamura T. New bioptic method for submucosal tumor of the gastrointestinal tract. Tohoku J. Exp. Med. 1986; 150: 401-6.
– reference: Ludwig K, Weiner R, Bernhardt J. Minimally invasive resections of gastric tumors. Chirurg 2003; 74: 632-7.
– reference: Yamamoto H, Sekine Y, Higashizawa T et al. Successful en bloc resection of a large superficial gastric cancer by using sodium hyaluronate and electrocautery incision forceps. Gastrointest. Endosc. 2001; 54: 629-32.
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Snippet Gastric submucosal tumor (SMT) is frequently found during screening endoscopy, but definitive diagnosis based on histological confirmation is relatively...
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StartPage 266
SubjectTerms Adult
Aged
Cohort Studies
complete resection
complications
Dissection - methods
Endoscopy
Endosonography
Feasibility Studies
Female
Gastric Mucosa - pathology
Gastric Mucosa - surgery
Humans
Male
Middle Aged
muscularis mucosa origin
Retrospective Studies
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
submucosal layer origin
Treatment Outcome
Young Adult
Title ENDOSCOPIC SUBMUCOSAL DISSECTION FOR GASTRIC SUBMUCOSAL TUMOR, ENDOSCOPIC SUB-TUMORAL DISSECTION
URI https://api.istex.fr/ark:/67375/WNG-0N9RMMXK-V/fulltext.pdf
https://cir.nii.ac.jp/crid/1571417125807250688
https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fj.1443-1661.2009.00905.x
https://www.ncbi.nlm.nih.gov/pubmed/19961528
https://www.proquest.com/docview/733853281
Volume 21
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