Per oral endoscopic tumor (POET) resection for treatment of upper gastrointestinal subepithelial tumors
Publication in refereed journal


Times Cited
Altmetrics Information
.

Other information
AbstractBackgroundEndoscopic submucosal tunneling has evolved to allow endoscopic resection of subepithelial tumors of gastrointestinal tract without full-thickness perforation. This study aimed to investigate safety and efficacy of submucosal tunnel resection for these tumors.MethodPatients with subepithelial tumors (SET) located in esophagus, gastric cardia, lesser curvature, and antrum were recruited. The size of tumor was limited to <40mm. The procedures were performed under general anesthesia. A mucosal entrance was created 2cm proximal to the SET after submucosal injection. Submucosal tunnel was then extended and the tumor was dissected and mobilized with intact overlying mucosa. After complete dissection, the tumors would be retrieved per orally and mucosal entrance closed by endoclips.ResultsFrom June 2012 to December 2016, 51 patients with subepithelial tumors received POET. 39 patients had SET in stomach, 11 located in esophagus, and 1 in duodenum. The mean operative time was 90.4646.49min, while the mean size of the tumors was 20.71 +/- 14.05mm. The POET was converted to endoscopic full-thickness resection (EFTR) in three patients with gastric subepithelial tumors located at greater curvature. The overall complication rate was 4.0%, and there was no bleeding, mucosal dehiscence, or leakage. The time to resume diet was 1.7days, while the average hospital stay was 3.2 +/- 1.0days. The mean follow-up period was 19 +/- 16months, and only 1 patient developed recurrence of leiomyoma.ConclusionPer oral endoscopic tumor resection is safe and effective treatment for esophageal and gastric SET located at cardia, lesser curvature, and antrum. Currently, POET for treatment of upper GI SET is limited by the size and location of the tumor.
Acceptance Date17/12/2018
All Author(s) ListChiu PWY, Yip HC, Teoh AYB, Wong VWY, Chan SM, Wong SKH, Ng EKW
Journal nameSurgical Endoscopy
Year2019
Month4
Volume Number33
Issue Number4
PublisherSPRINGER
Pages1326 - 1333
ISSN0930-2794
LanguagesEnglish-United Kingdom
KeywordsSubepithelial tumors, Upper gastrointestinal tract, Submucosal tunnel endoscopic resection, Per oral endoscopic tumor resection, Therapeutic endoscopy
Web of Science Subject CategoriesSurgery;Surgery

Last updated on 2020-04-07 at 03:38