Endoscopic therapy for gastric stromal tumors originating from the muscularis propria.
OBJECTIVE
To explore endoscopic therapy methods for gastric stromal tumors originating from the muscularis propria.


METHODS
For 69 cases diagnosed as gastric stromal tumors originating from the muscularis propria, three types of endoscopic therapy were selected, based on the size of the tumor. These methods included endoscopic ligation and resection (ELR), endoscopic submucosal excavation (ESE) and endoscopic full-thickness resection (EFR). The wound surface and the perforation of the gastric wall were closed with metal clips. Immunohistostaining for CD34, CD117, Dog-1, S-100 and smooth muscle actin (SMA) was performed on the resected tumors.


RESULTS
A total of 38 cases in which the tumor size was less than 1.2 cm were treated with ELR; three cases were complicated by perforation, and the perforations were closed with metal clips. Additionally, 18 cases in which the tumor size was more than 1.5 cm were treated with ESE, and no perforation occurred. Finally, 13 cases in which the tumor size was more than 2.0 cm were treated with EFR; all of the cases were complicated by artificial perforation, and all of the perforations were closed with metal clips. All of the 69 cases recovered with medical treatment, and none required surgical operation. Immunohistostaining demonstrated that among all of the 69 gastric stromal tumors diagnosed by gastroscopy, 12 cases were gastric leiomyomas (SMA-positive), and the other 57 cases were gastric stromal tumors.


CONCLUSIONS
Gastric stromal tumors originating from the muscularis propria can be treated successfully with endoscopic techniques, which could replace certain surgical operations and should be considered for further application.
Department of Gastroenterology, Yantai Yu Huang Ding Hospital, Yantai 264000, Shandong Province, China.
Liu-Ye
LY
Huang
Jun
J
Cui
Yun-Xiang
YX
Liu
Cheng-Rong
CR
Wu
De-Liang
DL
Yi
D000199:Actins / Q000378:metabolism; D000328:Adult; D000368:Aged; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005753:Gastric Mucosa / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000378:metabolism; D009369:Neoplasms / Q000601:surgery*; D012008:Recurrence; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014945:Wound Healing
D000199:Actins