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- Document type:
- Journal Article; Research Support, Non-U.S. Gov't; Video-Audio Media
- Author(s):
- Schlag, C; Wilhelm, D; von Delius, S; Feussner, H; Meining, A
- Title:
- EndoResect study: endoscopic full-thickness resection of gastric subepithelial tumors.
- Abstract:
- Endoscopic resection of gastric subepithelial tumors (SETs) carries a high risk of perforation. New techniques such as use of the over-the-scope clip (OTSC) may enable secure endoscopic closure of perforations. We aimed to evaluate the feasibility of endoscopic resection of small gastric SETs using a grasp-and-snare technique followed by OTSC closure of the gastric wall if necessary.In this prospective study 20 consecutive patients who presented with gastric SETs <= 3 cm were enrolled. Endoscopic resection was performed using a double-channel endoscope, a tissue anchor and a monofilament snare. If perforation occurred, the aim was to achieve complete closure with a tissue twin grasper and the OTSC. Procedures were performed under laparoscopic control using a 5-mm optic, which was introduced via a single 5-mm trocar through the umbilicus. All patients were followed up for 3 months after the procedure.In 6 /20 patients a pure endoscopic approach was impossible and a switch to laparoscopic wedge resection was necessary (large tumor size in 2 /6 patients; mainly extraluminal growth in 4 /6 patients). Solely endoscopic resection was successfully performed in the remaining 14 patients. Amongst these, laparoscopic control was impossible in two cases. Perforation occurred in 6 /14 patients but gastric closure with the OTSC was performed successfully in all these cases. No complications occurred and follow-up was unremarkable.Endoscopic snare resection enables safe treatment of small gastric SETs (diameter <= 3 cm) and seems faster and easier to perform than other endoscopic resection techniques, such as endoscopic submucosal dissection (ESD) or submucosal tunneling. Perforations occurring after full-thickness resection can be adequately managed by OTSC closure. Solely endoscopic resection without laparoscopic control seems possible in selected patients with tumors known to have purely intraluminal growth.
- Journal title abbreviation:
- Endoscopy
- Year:
- 2013
- Journal volume:
- 45
- Journal issue:
- 1
- Pages contribution:
- 4-11
- Language:
- eng
- Fulltext / DOI:
- doi:10.1055/s-0032-1325760
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/23254401
- Print-ISSN:
- 0013-726X
- TUM Institution:
- Chirurgische Klinik und Poliklinik; II. Medizinische Klinik und Poliklinik (Gastroenterologie)
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