title: Endolumenal endoscopic full-thickness resection of muscularis propria-originating gastric submucosal tumors.
abstract: BACKGROUND
  This study retrospectively reviewed 48 cases of gastric submucosal tumors (SMTs) treated by endolumenal endoscopic full-thickness resection (EFR) microsurgery in our gastrointestinal endoscopy center.
  
  
  METHODS
  From November 2009 to October 2012, 48 cases underwent endolumenal EFR for resection of muscularis propria-originating gastric SMTs. Characteristics of the 48 patients, clinical efficacy, safety of EFR, and post-EFR pathological diagnoses were evaluated retrospectively.
  
  
  RESULTS
  EFR was successfully performed in 48 cases with 52 lesions. The median operation time was 59.72 minutes (range, 30-270 minutes; standard deviation, 39.72 minutes). The mean tumor size was 1.59 cm (range, 0.50-4.80 cm; standard deviation, 1.01 cm). During the EFR process, dual-channel gastroscopy was applied in 20 cases of SMTs, and paracentesis during the EFR process was applied in 9 cases. EFR for larger SMTs and gastric corpus-originating SMTs had longer operative times. Pathological diagnosis included 43 gastrointestinal stromal tumors, 4 leiomyomas, and 1 schwannoma. A larger tumor size was associated with higher risk of malignancy. No severe postoperative complications were observed. No tumor recurrences were confirmed in follow-up gastroscopy.
  
  
  CONCLUSIONS
  The endolumenal EFR technique proved to be feasible and minimally invasive, even for the resection of large gastric tumors originating from the muscularis propria. However, more data on EFR must be obtained and analyzed.
authors.affiliation: Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University , Nanjing, China .
authors.forename: Yadong
authors.initials: Y
authors.lastname: Feng
authors.forename: Lianzhen
authors.initials: L
authors.lastname: Yu
authors.forename: Shuping
authors.initials: S
authors.lastname: Yang
authors.forename: Xueliang
authors.initials: X
authors.lastname: Li
authors.forename: Jing
authors.initials: J
authors.lastname: Ding
authors.forename: Li
authors.initials: L
authors.lastname: Chen
authors.forename: Yinghong
authors.initials: Y
authors.lastname: Xu
authors.forename: Ruihua
authors.initials: R
authors.lastname: Shi
mesh_terms: D000328:Adult; D000368:Aged; D017130:Angioplasty / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology / Q000601:surgery*; D005773:Gastroscopy / Q000379:methods; D006801:Humans; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009442:Neurilemmoma / Q000473:pathology / Q000601:surgery*; D061646:Operative Time; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome