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Endoscopic Submucosal Dissection for Gastric Subepithelial Tumors: A Single-Center Experience.

Lee JS, Kim GH, Park do Y, Yoon JM, Kim TW, Seo JH, Lee BE, Song GA - Gastroenterol Res Pract (2015)

Bottom Line: Results.Procedure-related bleeding and perforation rates were both 4%.ESD is an effective, safe, and feasible treatment for gastric SETs.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan 602-739, Republic of Korea ; Biomedical Research Institute, Pusan National University Hospital, Busan 602-739, Republic of Korea.

ABSTRACT
Background and Aims. Endoscopic submucosal dissection (ESD) has been accepted as a treatment modality for gastrointestinal epithelial tumors. Recently, ESD has been applied to resect subepithelial tumors (SETs) in the gastrointestinal tract, but clinical evidence on its efficacy and safety is limited. The aim of this study was to investigate the efficacy and safety of ESD for gastric SETs and to assess possible predictive factors for incomplete resection. Patients and Methods. Between January 2006 and December 2013, a total of 49 patients with gastric SET underwent ESD at our hospital. Clinicopathologic characteristics of patients and SETs, therapeutic outcomes, complications, and follow-up outcomes were evaluated. Results. The overall rates of en bloc resection and complete resection were 88% (43/49) and 84% (43/49), respectively. Complete resection rates in tumors originating from the submucosal layer were significantly higher than those in tumors originating from the muscularis propria layer (90% versus 56%, P = 0.028). In multivariate logistic regression analyses, tumor location (upper third: odds ratio [OR] 12.639, 95% confidence interval [CI] 1.087-146.996, P = 0.043) and layer of tumor origin (muscularis propria: OR 8.174, 95% CI 1.059-63.091, P = 0.044) were independently associated with incomplete resection. Procedure-related bleeding and perforation rates were both 4%. No recurrence was observed in patients with complete resection at a median follow-up period of 29 months (range: 7-83 months). Conclusions. ESD is an effective, safe, and feasible treatment for gastric SETs. The frequency of incomplete resection increases in tumors located in the upper third of the stomach and in those originating from the muscularis propria layer.

No MeSH data available.


Related in: MedlinePlus

Flowchart of patients included in the study. SETs: subepithelial tumors; SM: submucosa; MP: muscularis propria.
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Related In: Results  -  Collection


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fig1: Flowchart of patients included in the study. SETs: subepithelial tumors; SM: submucosa; MP: muscularis propria.

Mentions: We retrospectively analyzed our database of all patients who underwent ESD at the Pusan National University Hospital (Busan, Korea) between January 2006 and December 2013. We identified a total of 49 patients who underwent ESD for gastric SETs (Figure 1). All patients underwent EUS before the procedure and agreed to undergo ESD after explanation of the risks and benefits, including complications of ESD and the possible necessity for additional surgical treatment. Patients with well-differentiated neuroendocrine tumor (WDNET) underwent abdominal computed tomography (CT) to determine the presence of lymph node or distant metastases before ESD. Written informed consent was obtained from all patients before ESD, and the study protocol was reviewed and approved by the Institutional Review Board of Pusan National University Hospital.


Endoscopic Submucosal Dissection for Gastric Subepithelial Tumors: A Single-Center Experience.

Lee JS, Kim GH, Park do Y, Yoon JM, Kim TW, Seo JH, Lee BE, Song GA - Gastroenterol Res Pract (2015)

Flowchart of patients included in the study. SETs: subepithelial tumors; SM: submucosa; MP: muscularis propria.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4548140&req=5

fig1: Flowchart of patients included in the study. SETs: subepithelial tumors; SM: submucosa; MP: muscularis propria.
Mentions: We retrospectively analyzed our database of all patients who underwent ESD at the Pusan National University Hospital (Busan, Korea) between January 2006 and December 2013. We identified a total of 49 patients who underwent ESD for gastric SETs (Figure 1). All patients underwent EUS before the procedure and agreed to undergo ESD after explanation of the risks and benefits, including complications of ESD and the possible necessity for additional surgical treatment. Patients with well-differentiated neuroendocrine tumor (WDNET) underwent abdominal computed tomography (CT) to determine the presence of lymph node or distant metastases before ESD. Written informed consent was obtained from all patients before ESD, and the study protocol was reviewed and approved by the Institutional Review Board of Pusan National University Hospital.

Bottom Line: Results.Procedure-related bleeding and perforation rates were both 4%.ESD is an effective, safe, and feasible treatment for gastric SETs.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan 602-739, Republic of Korea ; Biomedical Research Institute, Pusan National University Hospital, Busan 602-739, Republic of Korea.

ABSTRACT
Background and Aims. Endoscopic submucosal dissection (ESD) has been accepted as a treatment modality for gastrointestinal epithelial tumors. Recently, ESD has been applied to resect subepithelial tumors (SETs) in the gastrointestinal tract, but clinical evidence on its efficacy and safety is limited. The aim of this study was to investigate the efficacy and safety of ESD for gastric SETs and to assess possible predictive factors for incomplete resection. Patients and Methods. Between January 2006 and December 2013, a total of 49 patients with gastric SET underwent ESD at our hospital. Clinicopathologic characteristics of patients and SETs, therapeutic outcomes, complications, and follow-up outcomes were evaluated. Results. The overall rates of en bloc resection and complete resection were 88% (43/49) and 84% (43/49), respectively. Complete resection rates in tumors originating from the submucosal layer were significantly higher than those in tumors originating from the muscularis propria layer (90% versus 56%, P = 0.028). In multivariate logistic regression analyses, tumor location (upper third: odds ratio [OR] 12.639, 95% confidence interval [CI] 1.087-146.996, P = 0.043) and layer of tumor origin (muscularis propria: OR 8.174, 95% CI 1.059-63.091, P = 0.044) were independently associated with incomplete resection. Procedure-related bleeding and perforation rates were both 4%. No recurrence was observed in patients with complete resection at a median follow-up period of 29 months (range: 7-83 months). Conclusions. ESD is an effective, safe, and feasible treatment for gastric SETs. The frequency of incomplete resection increases in tumors located in the upper third of the stomach and in those originating from the muscularis propria layer.

No MeSH data available.


Related in: MedlinePlus