PMID- 29499127
OWN - NLM
STAT- MEDLINE
DCOM- 20181211
LR  - 20220331
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 88
IP  - 1
DP  - 2018 Jul
TI  - Submucosal tunnel endoscopic resection for extraluminal tumors: a novel 
      endoscopic method for en bloc resection of predominant extraluminal growing 
      subepithelial tumors or extra-gastrointestinal tumors (with videos).
PG  - 160-167
LID - S0016-5107(18)30146-9 [pii]
LID - 10.1016/j.gie.2018.02.032 [doi]
AB  - BACKGROUND AND AIMS: The management of subepithelial tumors with a predominant 
      extraluminal growth pattern or extra-GI tumors can be challenging and 
      traditionally requires a surgical resection that is not only invasive but may 
      carry a significant risk of morbidity and mortality. We aimed to assess the 
      feasibility, safety, and efficacy of a novel endoscopic technique termed 
      submucosal tunnel endoscopic resection for extraluminal tumors (STER-ET). 
      METHODS: We prospectively enrolled patients who underwent STER-ET for GI 
      subepithelial tumors with a predominant extraluminal growth pattern or extra-GI 
      tumors located at the level of cardia or the proximal part of the lesser 
      curvature of the stomach seen on cross-sectional imaging between January 2016 and 
      March 2017. RESULTS: Eight patients underwent STER-ET. The mean (+/- standard 
      deviation) tumor size was 2.8 +/- 0.6 cm and 2.3 +/- 0.8 cm in longest and shortest 
      dimension, respectively. The average procedure time was 67 +/- 4.4 minutes. The 
      rates of curative en bloc resection and en bloc retrieval was 100% and 87.5%, 
      respectively. On final histology, 6 tumors were GI stromal tumors, 1 was a 
      schwannoma, and 1 was a foregut cyst. Five patients had capnoperitoneum during 
      the procedure and required abdominal decompression. One patient had a small 
      mucosotomy successfully treated with a hemostatic clip. There were no major 
      adverse events or deaths. The median length of hospital stay was 3 days. There 
      was no residual tumor on surveillance imaging after a mean follow-up period of 
      10.0 +/- 2.1 months. CONCLUSIONS: STER-ET is a novel technique that appears to be 
      safe and effective in achieving a curative resection for GI subepithelial tumors 
      with a predominantly extraluminal growth pattern or extraluminal tumors in a 
      selected group of patients. However, larger studies are required to validate our 
      finding.
CI  - Copyright (c) 2018 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Cai, Ming-Yan
AU  - Cai MY
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China.
FAU - Zhu, Bo-Qun
AU  - Zhu BQ
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China.
FAU - Xu, Mei-Dong
AU  - Xu MD
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China.
FAU - Qin, Wen-Zheng
AU  - Qin WZ
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China.
FAU - Zhang, Yi-Qun
AU  - Zhang YQ
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China.
FAU - Chen, Wei-Feng
AU  - Chen WF
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China.
FAU - Ooi, Marie
AU  - Ooi M
AD  - Department of Gastroenterology, Royal Adelaide Hospital, South Adelaide, 
      Australia.
FAU - Li, Quan-Lin
AU  - Li QL
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China.
FAU - Yao, Li-Qing
AU  - Yao LQ
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China.
FAU - Zhou, Ping-Hong
AU  - Zhou PH
AD  - Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan 
      University, Shanghai, China.
LA  - eng
PT  - Journal Article
PT  - Video-Audio Media
DEP - 20180227
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
MH  - Aged
MH  - Cysts/diagnostic imaging/pathology/*surgery
MH  - Endoscopic Mucosal Resection/*methods
MH  - Endoscopy, Digestive System/*methods
MH  - Esophagogastric Junction/diagnostic imaging/pathology/*surgery
MH  - Female
MH  - Gastrointestinal Stromal Tumors/diagnostic imaging/pathology/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neurilemmoma/diagnostic imaging/pathology/*surgery
MH  - Prospective Studies
MH  - Stomach Neoplasms/diagnostic imaging/pathology/*surgery
MH  - Tomography, X-Ray Computed
MH  - Tumor Burden
EDAT- 2018/03/03 06:00
MHDA- 2018/12/12 06:00
CRDT- 2018/03/03 06:00
PHST- 2017/10/31 00:00 [received]
PHST- 2018/02/20 00:00 [accepted]
PHST- 2018/03/03 06:00 [pubmed]
PHST- 2018/12/12 06:00 [medline]
PHST- 2018/03/03 06:00 [entrez]
AID - S0016-5107(18)30146-9 [pii]
AID - 10.1016/j.gie.2018.02.032 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2018 Jul;88(1):160-167. doi: 10.1016/j.gie.2018.02.032. Epub 
      2018 Feb 27.