title: Endoscopic ligation and resection for the treatment of small EUS-suspected gastric GI stromal tumors.
abstract: 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.
authors.affiliation: Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Wen-Hsin
authors.initials: WH
authors.lastname: Huang
authors.forename: Chun-Lung
authors.initials: CL
authors.lastname: Feng
authors.forename: Hsueh-Chou
authors.initials: HC
authors.lastname: Lai
authors.forename: Cheng-Ju
authors.initials: CJ
authors.lastname: Yu
authors.forename: Jen-Wei
authors.initials: JW
authors.lastname: Chou
authors.forename: Cheng-Yuan
authors.initials: CY
authors.lastname: Peng
authors.forename: Mei-Du
authors.initials: MD
authors.lastname: Yang
authors.forename: I-Ping
authors.initials: IP
authors.lastname: Chiang
mesh_terms: 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*