Clin Endosc.  2018 Jan;51(1):19-27. 10.5946/ce.2018.020.

Endoscopic Treatment of Subepithelial Tumors

• Kim SY
• Kim KO

• KMID: 2403628
• DOI: http://doi.org/10.5946/ce.2018.020

Abstract

Gastrointestinal subepithelial tumors (SETs) are generally found during endoscopy and their incidence has gradually increased. Although the indications for the endoscopic treatment of patients with SETs remain to be established, the feasibility and safety of endoscopic dissection, including the advantages of this method compared with surgical treatment, have been validated in many studies. The development of endoscopic techniques, such as endoscopic submucosal dissection, endoscopic enucleation, endoscopic excavation, endoscopic submucosal tunnel dissection, submucosal tunnel endoscopic resection, and endoscopic full-thickness resection has enabled the removal of SETs while reducing the occurrence of complications. Here, we discuss the endoscopic treatment of patients with SETs, outcomes for endoscopic treatment, and procedure-related complications. We also consider the advantages and disadvantages of the various endoscopic techniques.

Keyword

Endoscopic resection; Gastrointestinal tract; Subepithelial tumor

MeSH Terms

Endoscopy
Gastrointestinal Tract
Humans
Incidence
Methods

Figure

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  Fig. 1. Endoscopic submucosal dissection of a gastrointestinal stromal tumor. (A) A large subepithelial tumor is observed at the high body of the stomach. (B, C) Circumferential incision and submucosal dissection of the tumor is performed. (D) Most of the subepithelial tumor is exposed to the lumen. (E) A post-endoscopic submucosal dissection ulcer is observed. (F) The resected specimen (tumor size is 2.4 cm).

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  Fig. 2. Endoscopic excavation with clipping of a gastrointestinal stromal tumor. (A) A large and round subepithelial tumor is found at the high body of the stomach. (BD) After the mucosa overlying the lesion is cut, the subepithelial tumor is excavated from the muscularis propria layer. (E) The wound is closed endoscopic clips. (F) The resected specimen (tumor size is 2.0 cm).

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