Optimal Endoscopic Resection Technique for Selected Gastric GISTs. The Endoscopic Suturing System Combined with ESD—a New Alternative?
Autor: | Joanna Szełemej, Katarzyna M. Pawlak, Katarzyna Wojciechowska, Artur Raiter, Katarzyna Kozłowska-Petriczko, Anna Wiechowska-Kozłowska, Jan Petriczko |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Endoscopic ultrasound
medicine.medical_specialty lcsh:Medicine ESD Article 03 medical and health sciences 0302 clinical medicine endoscopic resection Biopsy medicine Endoscopic resection EFTR Antrum GISTs GiST medicine.diagnostic_test business.industry lcsh:R General Medicine Optimal management digestive system diseases endoscopic suturing system Safety profile 030220 oncology & carcinogenesis Very low risk 030211 gastroenterology & hepatology Radiology business |
Zdroj: | Journal of Clinical Medicine Volume 9 Issue 6 Journal of Clinical Medicine, Vol 9, Iss 1776, p 1776 (2020) |
ISSN: | 2077-0383 |
DOI: | 10.3390/jcm9061776 |
Popis: | Background and Study Aim: In terms of therapeutic management, gastrointestinal stromal tumors (GISTs) seem to be the most difficult group of subepithelial gastrointestinal lesions (SELs). Despite various treatment option, choice of optimal management remains a dilemma in daily practice. Our aim was to evaluate a new hybrid resection technique of gastric GISTs type III as a modality of endoscopic full-thickness resection. Methods: Three males and one female (mean age of 68) were qualified for the procedure. Endoscopic full-thickness resections consisted of the endoscopic resection combined with suturing by Apollo OverStitch System. The main inclusion criterium was a complete diagnosis of GISTs (computed tomography (CT), endoscopic ultrasound (EUS), fine-needle biopsy (FNB)) with the evaluation of the tumor features, especially, the location in the gastric wall. All of the tumors were type III with a diameter between 20&ndash 40 mm. The lesions were located in the corpus (1), antrum (1) and between gastric body and fundus (2). All procedures were performed in 2019. Results: The technical and therapeutic success rate was 100% and the mean resection time 107.5 min. Neither intra- nor postprocedural complications were observed. In all four cases, R0 resection was achieved. Histopathologic assessment confirmed GIST with < 5mitose/50HPF in all of the tumors, with very low risk. Conclusion: Based on our outcomes, endoscopic resection combined with the sewing by Apollo OverStitch of gastric GISTs type III, with the diameter between 20&ndash 40 mm, seems to be an effective therapeutic option with a good safety profile, however further studies with a larger treatment group are needed. |
Databáze: | OpenAIRE |
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