Clin Endosc.  2021 Jan;54(1):131-135. 10.5946/ce.2020.070.

Endoscopic Full-Thickness Resection for Gastric Subepithelial Lesions Arising from the Muscularis Propria

• Jung AL
• Park SW
• Hong GY
• Moon HC
• Eun SJ

• KMID: 2512319
• DOI: http://doi.org/10.5946/ce.2020.070

Abstract

Most cases of gastric subepithelial lesions follow a good clinical course; however, some lesions progress to malignant tumors, and treatment of tumors with a high risk of malignancy is essential. Surgical excision has been the primary treatment for tumors originating from the propria muscle layer, but it has the disadvantages of being invasive and causing postoperative functional abnormalities. With the development of endoscopic techniques and instruments, the role of endoscopic resection, which is a less invasive method for the removal of gastric subepithelial lesions, has been attracting attention. We performed an endoscopic full-thickness resection for 8 patients with gastric subepithelial lesions originating from the muscularis propria. No fatal complications occurred. Our findings suggest the need to develop various devices for resection and closure and to accumulate further experience through additional studies to prevent complications and specimen loss.

Keyword

Endoscopic full-thickness resection; Gastric subepithelial lesions; Gastrointestinal stromal tumors

Figure

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  Fig. 1. Endoscopic full-thickness resection of a subepithelial lesion originating from the muscularis propria. (A) A subepithelial lesion originating from the muscularis propria. (B) By using a snare, the mucosa and submucosa covering the lesion are removed to expose the lesion. (C) A small perforation is made through an incision at the border of the lesion by using an incision knife. Then, an IT knife is inserted in the perforation hole, and the entire layer around the lesion is cut. (D) The perforation after complete resection with a snare. (E) The perforation is sealed with endoscopic metal clips. (F) Resected tissue (intraperitoneal lesions, mostly covered with normal serosa).

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