title: Endoscopic submucosal dissection for treatment of gastric submucosal tumors originating from the muscularis propria layer.
abstract: OBJECTIVE
  We aimed to study the feasibility of endoscopic submucosal dissection (ESD) for the removal of gastric muscularis propria tumors and to evaluate the efficacy and safety of ESD for this treatment.
  
  
  METHODS
  Eighteen patients with gastric SMTs originating from the muscularis propria were treated by ESD between July 2008 and July 2011. Tumor characteristics, complications, en bloc resection rate, and local recurrence rate were evaluated.
  
  
  RESULTS
  Among the 18 patients, 11 were women (61.1 %). The median age was 65.3 ± 6.3 years old (range 30-71 years old). Seventeen tumors were resected completely by ESD (success rate 94.4 %). The mean tumor size as determined by endoscopic ultrasound was 2.6 ± 1.2 cm (range 1.0-3.5 cm). The histological diagnosis was gastrointestinal stromal tumor for 13 lesions and leiomyoma for four tumors. The mean operation time was 90 ± 38 min (range 50-120 min), and the average blood loss was 20 ml. Two patients developed perforation, which was closed by endoscopic methods with metallic clips. The tumor was closely adhered to the muscularis propria and was convex to the enterocoelia in one case. No single case had severe complications, such as GI bleeding, peritonitis, or abdominal abscess, and there were no other immediate post-procedure complications.
  
  
  CONCLUSIONS
  ESD is a safe, effective, well-tolerated, and minimally invasive therapy for the intraluminal SMTs originating from gastric muscularis propria with relatively few complications. Although there is a risk of perforation which has become manageable endoscopically.
authors: Department of Gastroenterology, The First Affiliated Hospital, Zhejiang Chinese Medical University, Youdian Road No. 54, Hangzhou, 310006, China. zhangshuo@medmail.com.cn
authors: Shuo
authors: S
authors: Zhang
authors: Guan-Qun
authors: GQ
authors: Chao
authors: Men
authors: M
authors: Li
authors: Gui-Bao
authors: GB
authors: Ni
authors: Bin
authors: B
authors: Lv
mesh_terms: D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000601:surgery*; D046152:Gastrointestinal Stromal Tumors / Q000601:surgery*; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D007889:Leiomyoma / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome
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