title: Endoscopic dissection of large endogenous myogenic tumors in the esophagus and stomach is safe and feasible: a report of 42 cases.
abstract: OBJECTIVE
  Submucosal myogenic tumors, including leiomyoma and stromal tumors, are currently treated primarily by open surgery or laparoscopic excision. The aim of this retrospective study was to evaluate the feasibility of endoscopic dissection (ED) for resecting endogenous esophageal leiomyoma (EL) and gastric stromal tumors (GSTs) with diameters of 5 cm.
  
  
  METHODS
  We enrolled 42 patients with endogenous EL and GST who had undergone endoscopic surgery (endoscopic group). These cases were compared retrospectively with 22 patients who had undergone thoracotomy or laparotomy (control group). Endoscopic group (n = 42) received ED for EL and GST resection, including circumferential removal of superficial mucosa of targeted tumor. Control group (n = 22) received thoracotomy or laparotomy for resection of esophageal and gastric myogenic tumors. Main outcome measures were operative time, intraoperative bleeding and perforation, postoperative complications, and hospital stays and costs were compared between groups.
  
  
  RESULTS
  Endogenous EL and GST were successfully removed from all patients. Bleeding and perforation occurred in seven and five EL and GST patients, respectively. Bleeding was corrected with argon plasma coagulation (APC). Perforation was endoscopically repaired with clips. Mean operative time was 49 min for endoscopic EL and 55 min for GST resection. No major bleeding or perforation occurred postoperatively. Endoscopic treatment had shorter length of stay and lower hospital costs than conventional procedures.
  
  
  CONCLUSIONS
  ED is safe and feasible for resection of endogenous EL and GST in selected cases.
authors.affiliation: Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University, Chongqing, China. wangl28@medmail.com.cn
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.forename: Chao-Qiang
authors.initials: CQ
authors.lastname: Fan
authors.forename: Wei
authors.initials: W
authors.lastname: Ren
authors.forename: Xia
authors.initials: X
authors.lastname: Zhang
authors.forename: Yi-Hui
authors.initials: YH
authors.lastname: Li
authors.forename: Xiao-Yan
authors.initials: XY
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D004210:Dissection; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D004939:Esophageal Perforation; D004945:Esophagoscopy / Q000009:adverse effects; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology / Q000601:surgery*; D005773:Gastroscopy / Q000009:adverse effects; D006801:Humans; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D013997:Time Factors