Endoscopic management of gastrointestinal smooth muscle tumor.
OBJECTIVE
To systematically evaluate the efficacy and safety of endoscopic resection of gastrointestinal smooth muscle tumors (SMTs, including leiomyoma and leiomyosarcoma) and to review our preliminary experiences on endoscopic diagnosis of gastrointestinal SMTs.


METHODS
A total of 69 patients with gastrointestinal SMT underwent routine endoscopy in our department. Endoscopic ultrasonography (EUS) was also performed in 9 cases of gastrointestinal SMT. The sessile submucosal gastrointestinal SMTs with the base smaller than 2 cm in diameter were resected by "pushing" technique or "grasping and pushing" technique while the pedunculated SMTs were resected by polypectomy. For those SMTs originating from muscularis propria or with the base size >or= 2 cm, ordinary biopsy technique was performed in tumors with ulcers while the "Digging" technique was performed in those without ulcers.


RESULTS
54 cases of leiomyoma and 15 cases of leiomyosarcoma were identified. In them, 19 cases of submucosal leiomyoma were resected by "pushing" technique and 10 cases were removed by "grasping and pushing" technique. Three cases pedunculated submucosal leiomyoma were resected by polypectomy. No severe complications developed during or after the procedure. No recurrence was observed. The diagnostic accuracy of ordinary and the "Digging" biopsy technique was 90.0% and 94.1%, respectively.


CONCLUSIONS
Endoscopic resection is a safe and effective treatment for leiomyomas with the base size <or= 2 cm. The "digging" biopsy technique would be a good option for histologic diagnosis of SMTs.
Zhou
Xiao-Dong
XD
Department of Gastroenterology, First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China. zhouxd7612@hotmail.com.
Lv
Nong-Hua
NH
Chen
Hong-Xia
HX
Wang
Chong-Wen
CW
Zhu
Xuan
X
Xu
Ping
P
Chen
You-Xiang
YX
D000293:Adolescent; D000328:Adult; D000368:Aged; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000379:methods*; D019160:Endosonography; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007889:Leiomyoma / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged