title: Ligation-Assisted Endoscopic Enucleation for the Resection of Gastrointestinal Tumors Originating from the Muscularis Propria: Analysis of Efficacy and Facility.
abstract: BACKGROUND
  Gastrointestinal tumors originating from the muscularis propria are believed to have the potential to progress to malignant tumors. The efficacy of 'pre-management' with elastic band or endoloop assistant ligation after initial submucosal dissection in endoscopic enucleation procedure of these tumors was investigated and evaluated.
  
  
  METHODS
  The study included 21 patients with small gastric stromal tumors arising in the gastric muscularis propria as determined by endoscopy (endoscopic ultrasonography). A standard endoscope with a transparent cap attached to the tip was used. The cap was placed over the lesion, after incision of the surrounding tissue, maximum sustained suction was applied. Then the elastic band or endoloop was released around the base. Circumference resection was performed with clips strengthening the defect closure.
  
  
  RESULTS
  The 22 gastrointestinal stromal tumors sloughed completely. The mean time required for the full-thickness resection was 48 min. Minor perforation occurred with metal clips closing the defect of the gastric wall. Follow-up ranged from 13 to 42 months, during which time no recurrence was observed postoperatively.
  
  
  CONCLUSIONS
  The band or endoloop assistant endoscopic ligation technique is effective for the enucleation of deep gastric tumors. It may help avoiding disturbance the abdominal cavity hemostasis in traditional full-thickness enucleation procedure.
authors.affiliation: Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin, China.
authors.forename: Zhongqing
authors.initials: Z
authors.lastname: Zheng
authors.forename: Guohui
authors.initials: G
authors.lastname: Jiao
authors.forename: Tao
authors.initials: T
authors.lastname: Wang
authors.forename: Xin
authors.initials: X
authors.lastname: Chen
authors.forename: Bangmao
authors.initials: B
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D004210:Dissection / Q000009:adverse effects; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D019160:Endosonography; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008026:Ligation / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult