[Endoscopic submucosal dissection for gastrointestinal stromal tumors: a report of 20 cases].
OBJECTIVE
To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for the removal of small gastrointestinal stromal tumor (GIST).


METHODS
GIST diagnosed by endoscopic ultrasonography (EUS) was managed by ESD with the needle knife as follows:(1)Injecting normal saline into the submucosa. (2)Pre-cutting the surrounding mucosa of the lesion. (3) Dissecting the submucosal tissue to display GIST and resecting the lesion completely.


RESULTS
Of 20 GISTs, 12 located in gastric fundus, and 1 in gastric antrum, 3 in gastric body and 4 in rectum. Lesion diameter ranged from 0.5 to 3.2 cm and the mean resected size was 1.6 cm. Among 20 lesions, 19 were resected with ESD completely, and 1 received additional operation because of tumor residual in the wound after ESD. The success rate of ESD was 95.0% (19/20). The mean ESD procedure time was 87.5 min (ranging from 60 to 150 min). None of the patients had delayed bleeding after ESD. Perforations occurred in 3 cases after the dissection of the GIST, which were closed with metallic endoclips without additional surgical suture. The perforation rate of ESD was 15.0% (3/20). The follow up ranged from 2 to 12 months, and no recurrence was observed by EUS except the above-mentioned case undergone additional operation.


CONCLUSIONS
ESD is effective and safe for small GIST, which can resect the whole lesion and provide pathological information.
Zhou
Ping-Hong
PH
Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Yao
Li-Qing
LQ
Qin
Xin-Yu
XY
D000328:Adult; D000368:Aged; D013505:Digestive System Surgical Procedures / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D019160:Endosonography; D004945:Esophagoscopy; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000601:surgery*; D046152:Gastrointestinal Stromal Tumors / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged