Endoscopic full-thickness resection of gastric subepithelial tumors: a single-center series.
OBJECTIVE
Endoscopic full-thickness resection of gastric subepithelial tumors with a full-thickness suturing device has been described as feasible in two small case series. The aim of this study was to evaluate the efficacy, safety, and clinical outcome of this resection technique.


METHODS
After 31 patients underwent endoscopic full-thickness resection, the data were analyzed retrospectively. Before snare resection, 1 to 3 full-thickness sutures were placed underneath each tumor with a device originally designed for endoscopic anti-reflux therapy.


RESULTS
All tumors were resected successfully. Bleeding occurred in 12 patients (38.7 %); endoscopic hemostasis could be achieved in all cases. Perforation occurred in 3 patients (9.6 %), and all perforations could be managed endoscopically. Complete resection was histologically confirmed in 28 of 31 patients (90.3 %). Mean follow-up was 213 days (range, 1 - 1737), and no tumor recurrences were observed.


CONCLUSIONS
Endoscopic full-thickness resection of gastric subepithelial tumors with the suturing technique described above is feasible and effective. After the resection of gastrointestinal stromal tumors (GISTs), we did not observe any recurrences during follow-up, indicating that endoscopic full-thickness resection may be an alternative to surgical resection for selected patients.
Department of Gastroenterology and Oncology, Klinikum Ludwigsburg, Ludwigsburg, Germany.
Arthur
A
Schmidt
Department of Gastroenterology and Oncology, Klinikum Ludwigsburg, Ludwigsburg, Germany.
Markus
M
Bauder
Department of Gastroenterology and Oncology, Klinikum Ludwigsburg, Ludwigsburg, Germany.
Bettina
B
Riecken
Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Canada.
Daniel
D
von Renteln
Department of Pathology, Klinikum Ludwigsburg, Ludwigsburg, Germany.
Helmut
H
Muehleisen
Department of Gastroenterology and Oncology, Klinikum Ludwigsburg, Ludwigsburg, Germany.
Karel
K
Caca
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology / Q000601:surgery*; D005773:Gastroscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D016558:Hemostasis, Endoscopic; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013270:Stomach / Q000293:injuries; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D013536:Suture Techniques / Q000009:adverse effects; D013537:Sutures