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Snare-assisted endoscopic resection of gastric subepithelial tumors originating from the muscularis propria layer: a multicenter study

  • Hongwu Zhu
  • Dongtao Shi
  • Hong Song
  • Meihua Zhou
  • Dayong Sun
  • Rui LiEmail author
  • Yagang ZhaoEmail author
Article
  • 36 Downloads

Abstract

Background and Aim

Although successful endoscopic resection of gastric subepithelial tumors (SETs) originating from the muscularis propria (MP) layer has been frequently reported, it requires a relatively complicated technique and has a high perforation rate. In this retrospective study, we evaluated the efficacy and safety of the snare-assisted endoscopic resection (SAER) method which is performed using a snare and insulated-tip (IT) knife via a single-channel endoscope to reduce the perforation rate.

Methods

In this study, fifty-six patients with gastric SETs originating from the MP layer treated by the SAER method at three institutions between July 2017 and December 2017 were reviewed. The procedure involved multiple steps as shown in Fig. 2. Data were obtained on demographics, SET features, histopathological diagnoses, procedure time, en bloc resection rate, R0 resection (negative margins) status, and adverse events.

Results

Endoscopic resection was successfully performed in all patients. The median overall procedure time was 43.5 min (range 26–106 min). The mean size of resected specimens was 19.73 mm (range 10–33 mm). The overall rate of en bloc resection was 96.4% (54/56). In addition, the perforation rate was 7.1% (4/56), and defects in the stomach wall were very small and easily closed using metallic clips. No postprocedural bleeding occurred in any case.

Conclusions

The SAER method is an effective, safe, less costly technique for the removal of some gastric SETs originating from the MP layer with an appropriate size.

Keywords

Endoscopic resection Gastric subepithelial tumor Muscularis propria layer Snare Perforation Bleeding 

Abbreviations

SAER

Snare-assisted endoscopic resection

SETs

Subepithelial tumors

MP

Muscularis propria

IT

Insulated-tip

GISTs

Gastrointestinal stromal tumors

EUS

Endoscopic ultrasound

HPF

High-power field

NCCN

National Comprehensive Cancer Network

Notes

Acknowledgements

We sincerely thank the staff of the endoscopy unit at General Hospital of Southern Theater Command of PLA, the First Affiliated Hospital of Soochow University, and the Clifford Hospital for their excellent technical assistance in conducting this study.

Funding

This study was supported by combined grants from the National Natural Science Foundation of China (No. 81602170), the Natural Science Foundation of Guangdong province (No. 2014A030313595), the Science and Technology Plan Project of Guangzhou City (Nos. 201804010039 and 201607010077), and the Youth Medical Key Talent Project of Jiangsu province (No. QNRC2016705).

Compliance with ethical standards

Disclosures

Hongwu Zhu, Dongtao Shi, Hong Song, Meihua Zhou, Dayong Sun, Rui Li, and Yagang Zhao have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of GastroenterologyGeneral Hospital of Southern Theater Command of People’s Liberation Army (PLA)GuangzhouChina
  2. 2.Department of GastroenterologyThe First Affiliated Hospital of Soochow UniversitySuzhouChina
  3. 3.Department of GastroenterologyClifford HospitalGuangzhouChina

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