Endoscopic ligation and resection for the treatment of small EUS-suspected gastric GI stromal tumors.
BACKGROUND
GI stromal tumors (GISTs), with their potential for malignant transformation, are usually treated by surgical intervention. Endoscopic treatment remains controversial.


OBJECTIVE
The aim of this study was to investigate clinical outcomes associated with use of endoscopic ligation and resection for diagnosis and treatment of small EUS-suspected gastric GISTs.


METHODS
Prospective case series.


METHODS
Academic medical center.


METHODS
Eight patients with submucosal gastric tumors <2 cm in diameter suspected to be GISTs.


METHODS
Endoscopic ligation and resection.


METHODS
Clinical/technical feasibility, success, and adverse events.


RESULTS
Seven patients with small EUS-suspected gastric GISTs were successfully treated by endoscopic ligation, with sloughing of residual tissue within 1 month. All were diagnosed pathologically with GISTs of low malignant potential. One additional patient required a second ligation to remove residual tumor, also diagnosed as a GIST with low malignant potential. No perforation, massive hemorrhage, or other complication requiring endoscopic or surgical intervention occurred.


CONCLUSIONS
Small number of patients (n = 8) and limited follow-up; risk of microscopically positive margins, which limits application to lesions strongly suspected to be benign.


CONCLUSIONS
Endoscopic ligation and resection shows promise as a safe and feasible technique to treat small EUS-suspected gastric GISTs. Controlled clinical trials with more subjects and longer follow-up are needed to confirm the value and limitations of this method.
Huang
Wen-Hsin
WH
Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
Feng
Chun-Lung
CL
Lai
Hsueh-Chou
HC
Yu
Cheng-Ju
CJ
Chou
Jen-Wei
JW
Peng
Cheng-Yuan
CY
Yang
Mei-Du
MD
Chiang
I-Ping
IP
D000368:Aged; D019160:Endosonography; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000000981:diagnostic imaging / Q000601:surgery*; D005773:Gastroscopy; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*