Endoscopic band ligation without electrosurgery: a new technique for excision of small upper-GI leiomyoma.
BACKGROUND
Leiomyoma is a relatively common submucosal tumor in the upper-GI tract. The efficacy of a new method for resection of these tumors, endoscopic band ligation, was evaluated.


METHODS
The study included 59 patients with 64 small upper-GI leiomyomas arising in the muscularis propria as determined by endoscopy, EUS, and EUS-guided FNA. The distribution of the 64 leiomyomas was the following: esophageal, 50; gastric, 12; duodenal, 2. A standard endoscope with a transparent cap attached to the tip was used. The cap was placed over the lesion, maximum sustained suction was applied, and an elastic band was released around the base. Beginning 2 weeks after banding, the lesions were observed endoscopically once per week until healing was complete.


RESULTS
The 50 esophageal leiomyomas sloughed completely. The mean time required for complete healing after band ligation was 3.6 weeks. Nine of the 12 gastric leiomyomas sloughed completely; the resulting ulcer defect was healed at a mean of 4.5 weeks. The other 3 lesions did not slough because they were not completely ligated. The two duodenal lesions sloughed completely after banding, and the mean time until healing of the defect was 4.5 weeks. No perforation occurred. Follow-up ranged from 16 to 31 months, during which time no recurrence was observed.


CONCLUSIONS
Endoscopic band ligation is an effective and safe treatment for small upper-GI leiomyoma.
Endoscopy Center, Second Clinical College of China Medical University, Sanhao Street 36, Shenyang 110004, China.
Siyu
S
Sun
Ye
Y
Jin
Guiyan
G
Chang
Caixia
C
Wang
Xiaoli
X
Li
Zhanhui
Z
Wang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D019160:Endosonography; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000000981:diagnostic imaging / Q000601:surgery*; D008026:Ligation; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*