A safe and efficient strategy for endoscopic resection of large, gastrointestinal lipoma.
BACKGROUND
Gastrointestinal (GI) lipomas are benign, slowly growing, submucosal tumors, which may cause gastrointestinal bleeding, anemia, intussusception, and bowel obstruction. The aim of this study is to explore the safe and effective strategy for endoscopic removal of large GI lipomas.


METHODS
During last 10 years, fifteen large and symptomatic GI lipomas were resected under endoscopy in our hospital. In them, two large lipomas with small stalk (< 2 m in diameter) were resected by polypectomy; ten large lipomas with base size greater than 2 cm in diameter were removed using a "subtotal resection." Three other large lipomas with small stalk (< 2 m in diameter) were resected by multistep resection. Endoscopic ultrasonography (EUS) and miniprobe endoscopic ultrasound were performed in six cases from January 2000 to July 2004 to confirm that those lesions were lipomas that were superficial to the muscularis propria.


RESULTS
All 15 lesions were successfully removed and were histopathologically confirmed to be lipomas. No severe complications, such as perforation or hemorrhage, developed after endoscopic removal. No recurrence was observed after 1-8 years follow-up endoscopic examination.


CONCLUSIONS
Various, large GI lipomas can be removed safely by electrosurgical snare resection under endoscopy following the guidance of the present therapeutic strategy.
Yu
H-G
HG
Department of Gastroenterology, Renmin Hospital of Wuhan University, Jiefang Road 238, 430060, Wuhan, People's Republic of China. yuyang68@public.wh.hb.cn
Ding
Y-M
YM
Tan
S
S
Luo
H-S
HS
Yu
J-P
JP
D000328:Adult; D000368:Aged; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000379:methods*; D019160:Endosonography; D005260:Female; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008067:Lipoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011183:Postoperative Complications / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome