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Endoscopic Resection for Submucosal Tumors

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Atlas of Digestive Endoscopic Resection

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Abstract

Submucosal tumors (SMTs) are common in upper GI tract and appears as elevated submucosal mass with intact overlying mucosa. These submucosal lesions, mainly arise from non-epithelial mesenchymal tissue in the GI wall, including stromal tumor, leiomyoma, lipoma or vascular tumors etc. EUS examination can usually determine characteristics the lesions. Snare polypectomy by electrocautery technique is simple and can obtain accurate pathological diagnosis. But there is risk of incomplete resection, postoperative bleeding and perforation. Ligation therapy is simple for thin pedicle lesions, with low risk of hemorrhage and perforation, but lack of postoperative pathologic diagnosis.

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References

  1. Spinelli P, Cerrai FG, Cambareri AR, Meroni E, Pizzetti P. Two-step endoscopic resection of gastric leiomyomas. Surg Endosc. 1993;7(2):90–2.

    Article  CAS  PubMed  Google Scholar 

  2. Lee SH, Park JH, Park do H, Chung IK, Kim HS, Park SH. Endoloop ligation of large pedunculated submucosal tumors (with videos). Gastrointest Endosc. 2008;67(3):556–60.

    Article  PubMed  Google Scholar 

  3. Huang WH, Feng CL, Lai HC, Yu CJ, Chou JW, Peng CY, et al. Endoscopic ligation and resection for the treatment of small EUS-suspected gastric GI stromal tumors. Gastrointest Endosc. 2010;71(6):1076–81. doi:10.1016/j.gie.2009.12.041.

    Article  PubMed  Google Scholar 

  4. Suzuki H, Ikeda K. Endoscopic mucosal resection and full thickness resection with complete defect closure for early gastrointestinal malignancies. Endoscopy. 2001;33(5):437–9. doi:10.1055/s-2001-14269.

    Article  CAS  PubMed  Google Scholar 

  5. Sumiyama K, Gostout CJ. Novel techniques and instrumentation for EMR, ESD, and full-thickness endoscopic luminal resection. Gastrointest Endosc Clin N Am. 2007;17(3):471–85. doi:10.1016/j.giec.2007.05.009, v–vi.

    Article  PubMed  Google Scholar 

  6. Elmunzer BJ, Waljee AK, Taylor JR, Rising GM, Trunzo JA, Elta GH, et al. Endoscopic full-thickness resection of gastric lesions using a novel grasp-and-snare technique: evaluation in a porcine survival model. Surg Endosc. 2010;24(7):1573–80. doi:10.1007/s00464-009-0813-8.

    Article  PubMed  Google Scholar 

  7. Kalloo AN, Singh VK, Jagannath SB, Niiyama H, Hill SL, Vaughn CA, et al. Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. Gastrointest Endosc. 2004;60(1):114–7.

    Article  PubMed  Google Scholar 

  8. Zhou PH, Yao LQ, Qin XY, Cai MY, Xu MD, Zhong YS, et al. Endoscopic full-thickness resection without laparoscopic assistance for gastric submucosal tumors originated from the muscularis propria. Surg Endosc. 2011;25(9):2926–31. doi:10.1007/s00464-011-1644-y.

    Article  PubMed  Google Scholar 

  9. Hashiba K, Carvalho AM, Diniz Jr G, Barbosa-de-Aridrade N, Guedes CA, Siqueira Filho L, et al. Experimental endoscopic repair of gastric perforations with an omental patch and clips. Gastrointest Endosc. 2001;54(4):500–4.

    Article  CAS  PubMed  Google Scholar 

  10. Binmoeller KF, Grimm H, Soehendra N. Endoscopic closure of a perforation using metallic clips after snare excision of a gastric leiomyoma. Gastrointest Endosc. 1993;39(2):172–4.

    Article  CAS  PubMed  Google Scholar 

  11. Minami S, Gotoda T, Ono H, Oda I, Hamanaka H. Complete endoscopic closure of gastric perforation induced by endoscopic resection of early gastric cancer using endoclips can prevent surgery (with video). Gastrointest Endosc. 2006;63(4):596–601. doi:10.1016/j.gie.2005.07.029.

    Article  PubMed  Google Scholar 

  12. Dray X, Giday SA, Buscaglia JM, Gabrielson KL, Kantsevoy SV, Magno P, et al. Omentoplasty for gastrotomy closure after natural orifice transluminal endoscopic surgery procedures (with video). Gastrointest Endosc. 2009;70(1):131–40. doi:10.1016/j.gie.2008.10.035.

    Article  PubMed  Google Scholar 

  13. Matsuda T, Fujii T, Emura F, Kozu T, Saito Y, Ikematsu H, et al. Complete closure of a large defect after EMR of a lateral spreading colorectal tumor when using a two-channel colonoscope. Gastrointest Endosc. 2004;60(5):836–8.

    Article  PubMed  Google Scholar 

  14. Shi Q, Chen T, Zhong YS, Zhou PH, Ren Z, Xu MD, et al. Complete closure of large gastric defects after endoscopic full-thickness resection, using endoloop and metallic clip interrupted suture. Endoscopy. 2013;45(5):329–34. doi:10.1055/s-0032-1326214.

    Article  CAS  PubMed  Google Scholar 

  15. Cios TJ, Reavis KM, Renton DR, Hazey JW, Mikami DJ, Narula VK, et al. Gastrotomy closure using bioabsorbable plugs in a canine model. Surg Endosc. 2008;22(4):961–6. doi:10.1007/s00464-007-9530-3.

    Article  PubMed  Google Scholar 

  16. Perretta S, Dallemagne B, Coumaros D, Marescaux J. Natural orifice transluminal endoscopic surgery: transgastric cholecystectomy in a survival porcine model. Surg Endosc. 2008;22(4):1126–30. doi:10.1007/s00464-007-9582-4.

    Article  CAS  PubMed  Google Scholar 

  17. Pham BV, Raju GS, Ahmed I, Brining D, Chung S, Cotton P, et al. Immediate endoscopic closure of colon perforation by using a prototype endoscopic suturing device: feasibility and outcome in a porcine model (with video). Gastrointest Endosc. 2006;64(1):113–9. doi:10.1016/j.gie.2005.11.046.

    Article  PubMed  Google Scholar 

  18. Ikeda K, Mosse CA, Park PO, Fritscher-Ravens A, Bergstrom M, Mills T, et al. Endoscopic full-thickness resection: circumferential cutting method. Gastrointest Endosc. 2006;64(1):82–9. doi:10.1016/j.gie.2005.12.039.

    Article  PubMed  Google Scholar 

  19. Kratt T, Kuper M, Traub F, Ho CN, Schurr MO, Konigsrainer A, et al. Feasibility study for secure closure of natural orifice transluminal endoscopic surgery gastrotomies by using over-the-scope clips. Gastrointest Endosc. 2008;68(5):993–6. doi:10.1016/j.gie.2008.06.057.

    Article  PubMed  Google Scholar 

  20. Kirschniak A, Kratt T, Stuker D, Braun A, Schurr MO, Konigsrainer A. A new endoscopic over-the-scope clip system for treatment of lesions and bleeding in the GI tract: first clinical experiences. Gastrointest Endos. 2007;66(1):162–7. doi:10.1016/j.gie.2007.01.034.

    Article  Google Scholar 

  21. Evans JA, Rosato FE, Ginsberg GG. Gastrostomy port assisted full-thickness gastric resection by using the peroral SurgASSIST introduced via an oroesophageal overtube in a porcine model. Gastrointest Endosc. 2007;65(4):684–7. doi:10.1016/j.gie.2006.09.020.

    Article  PubMed  Google Scholar 

  22. Trunzo JA, Cavazzola LT, Elmunzer BJ, Poulose BK, McGee MF, Schomish S, et al. Facilitating gastrotomy closure during natural-orifice transluminal endoscopic surgery using tissue anchors. Endoscopy. 2009;41(6):487–92. doi:10.1055/s-0029-1214721.

    Article  CAS  PubMed  Google Scholar 

  23. Katsarelias D, Polydorou A, Tsaroucha A, Pavlakis E, Dedemadi G, Pistiolis L, et al. Endoloop application as an alternative method for gastrotomy closure in experimental transgastric surgery. Surg Endosc. 2007;21(10):1862–5. doi:10.1007/s00464-007-9281-1.

    Article  CAS  PubMed  Google Scholar 

  24. von Renteln D, Schmidt A, Vassiliou MC, Rudolph HU, Caca K. Endoscopic full-thickness resection and defect closure in the colon. Gastrointest Endosc. 2010;71(7):1267–73. doi:10.1016/j.gie.2009.12.056.

    Article  Google Scholar 

  25. Sumiyama K, Gostout CJ, Rajan E, Bakken TA, Deters JL, Knipschield MA. Endoscopic full-thickness closure of large gastric perforations by use of tissue anchors. Gastrointest Endosc. 2007;65(1):134–9. doi:10.1016/j.gie.2006.01.050.

    Article  PubMed  Google Scholar 

  26. Wullstein C, Koppen M, Gross E. Laparoscopic treatment of colonic perforations related to colonoscopy. Surg Endosc. 1999;13(5):484–7.

    Article  CAS  PubMed  Google Scholar 

  27. Abe N, Mori T, Takeuchi H, Yoshida T, Ohki A, Ueki H, et al. Laparoscopic lymph node dissection after endoscopic submucosal dissection: a novel and minimally invasive approach to treating early-stage gastric cancer. Am J Surg. 2005;190(3):496–503. doi:10.1016/j.amjsurg.2005.05.042.

    Article  PubMed  Google Scholar 

  28. Abe N, Takeuchi H, Ohki A, Yanagida O, Masaki T, Mori T, et al. Long-term outcomes of combination of endoscopic submucosal dissection and laparoscopic lymph node dissection without gastrectomy for early gastric cancer patients who have a potential risk of lymph node metastasis. Gastrointest Endosc. 2011;74(4):792–7. doi:10.1016/j.gie.2011.06.006.

    Article  PubMed  Google Scholar 

  29. Saclarides TJ, Ko ST, Airan M, Dillon C, Franklin J. Laparoscopic removal of a large colonic lipoma. Report of a case. Dis Colon Rectum. 1991;34(11):1027–9.

    Article  CAS  PubMed  Google Scholar 

  30. Franklin Jr ME, Portillo G. Laparoscopic monitored colonoscopic polypectomy: long-term follow-up. World J Surg. 2009;33(6):1306–9. doi:10.1007/s00268-009-9967-8.

    Article  PubMed  Google Scholar 

  31. Yao LQ, Zhong YS, Xu MD, Xu JM, Zhou PH, Cai XL. Self-expanding metallic stents drainage for acute proximal colon obstruction. World J Gastroenterol. 2011;17(28):3342–6. doi:10.3748/wjg.v17.i28.3342.

    Article  PubMed  Google Scholar 

  32. Tilney HS, Lovegrove RE, Purkayastha S, Sains PS, Weston-Petrides GK, Darzi AW, et al. Comparison of colonic stenting and open surgery for malignant large bowel obstruction. Surg Endosc. 2007;21(2):225–33. doi:10.1007/s00464-005-0644-1.

    Article  CAS  PubMed  Google Scholar 

  33. Watt AM, Faragher IG, Griffin TT, Rieger NA, Maddern GJ. Self-expanding metallic stents for relieving malignant colorectal obstruction: a systematic review. Ann Surg. 2007;246(1):24–30. doi:10.1097/01.sla.0000261124.72687.72.

    Article  PubMed  Google Scholar 

  34. Cheung HY, Chung CC, Tsang WW, Wong JC, Yau KK, Li MK. Endolaparoscopic approach vs conventional open surgery in the treatment of obstructing left-sided colon cancer: a randomized controlled trial. Arch Surg. 2009;144(12):1127–32. doi:10.1001/archsurg.2009.216.

    Article  PubMed  Google Scholar 

  35. Jiang G, Zhao H, Yang F, Li J, Li Y, Liu Y, et al. Thoracoscopic enucleation of esophageal leiomyoma: a retrospective study on 40 cases. Dis Esophagus. 2009;22(3):279–83. doi:10.1111/j.1442-2050.2008.00883.x.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Endoscopy Center, Zhongshan Hospital Fudan University, Shanghai, People’s Republic of China

    Pinghong Zhou & Liqing Yao

  2. General surgery, Zhongshan Hospital Fudan University, Shanghai, People’s Republic of China

    Xinyu Qin

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  1. Pinghong Zhou
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  2. Liqing Yao
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  3. Xinyu Qin
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Editor information

Editors and Affiliations

  1. Endoscopy Center, Fudan University, Shanghai, China

    Pinghong Zhou

  2. Endoscopy Center, Fudan University, Shanghai, China

    Liqing Yao

  3. General surgery, Fudan University, Shanghai, China

    Xinyu Qin

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Zhou, P., Yao, L., Qin, X. (2014). Endoscopic Resection for Submucosal Tumors. In: Zhou, P., Yao, L., Qin, X. (eds) Atlas of Digestive Endoscopic Resection. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7933-4_5

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  • DOI: https://doi.org/10.1007/978-94-007-7933-4_5

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  • Online ISBN: 978-94-007-7933-4

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