Endoscopic solutions for patients with submucosal neoplasms of stomach

Close metadata

Recommended articles:

The choice of operative method in a patient with large esophageal schwannoma. Endoscopic Surgery. 2024;(6):51-56

Endoscopic resection of a giant tumor of the submucosal layer of the stomach causing periodic stenosis of its outlet. Endoscopic Surgery. 2025;(3):69-76

Diagnosis and treatment of three synchronous early squamous cell carcinomas of the esophagus: case report. Russian Journal of Evidence-Based Gastroenterology. 2025;(1):104-110

During the last few years endoscopy proceeded significantly in diagnosis and treatment of submucosal neoplasms of stomach. The possibility to reveal small tumors, forecast their nature and malignant potential created background for development and introduction of endoscopic methods. Endoscopic treatment nowadays includes not only different types of dissection in the submucosal layer but full-thickness resection as well. The location of the neoplasm defines the choice of the technique. Currently more and more papers about successful endoscopic treatment appear in literature though the question of choice of one or another method is still doubtful. This article summarizes up-to-date knowledge of indications for submucosal neoplasms endoscopic removal and provides data for choosing the appropriate approach.

Keywords:

submucosal tumors

non-epithelial lesions

submucosal tunneling endoscopic resection

endoscopic submucosal dissection

full-thickness resection

Authors:

Khvorova I.I.

A.S. Loginov Moscow Clinical Research Center

Shishin K.V.

Loginov Moscow Clinical Scientific Center

ORCID: 0000-0003-0010-5294

Nedoluzhko I.Yu.

A.S. Loginov Moscow Clinical Research Center

Shumkina L.V.

A.S. Loginov Moscow Clinical Research Center

Kurushkina N.A.

A.S. Loginov Moscow Clinical Research Center

Received:

04.08.2020

Accepted:

04.09.2020

List of references:

Kong SH, Yang HK. Surgical treatment of gastric gastrointestinal stromal tumor. J Gastric Cancer. 2013;13(1):3-18. https://doi.org/10.5230/jgc.2013.13.1.3
Novitsky YW, Kercher KW, Sing RF, Heniford BT. Long-term outcomes of laparoscopic resection of gastric gastrointestinal stromal tumors. Ann Surg. 2006;243(6):738-745. https://doi.org/10.1097/01.sla.0000219739.11758.27
Kang WZ, Xue LY, Wang GQ, Ma FH, Feng XL, Guo L, Li Y, Li W-K, Tian Y-T. Liposarcoma of the stomach: Report of two cases and review of the literature. World J Gastroenterol. 2018;24(25):2776-2784. https://doi.org/10.3748/wjg.v24.i25.2776
Li B, Liang T, Wei L, Ma M, Huang Y, Xu H, Shi X, Qin C. Endoscopic interventional treatment for gastric schwannoma: a single-center experience. Int J Clin Exp Pathol. 2014;7(10):6616-6625.
Morte D, Bingham J, Sohn V. Gastric Glomus Tumor: An Uncommon Source for an Acute Upper GI Bleed. Case Rep. Gastrointest Med. 2018. https://doi.org/10.1155/2018/7961981
Morales-Maza J, Pastor-Sifuentes FU, Sánchez-Morales GE, Ramos ES, Santes O, Clemente-Gutiérrez U, Pimienta-Ibarra AS, Medina-Franco H. Clinical characteristics and surgical treatment of schwannomas of the esophagus and stomach: A case series and systematic review. World J Gastrointest Oncol. 2019;11(9):750-760. https://doi.org/10.4251/wjgo.v11.i9.750
Ponsaing LG, Kiss K, Loft A, Jensen LI, Hansen MB. Diagnostic procedures for submucosal tumors in the gastrointestinal tract. World J Gastroenterol. 2007;13(24):3301-3310. https://doi.org/10.3748/wjg.v13.i24.3301
Tomofuji K, Watanabe J, Ishida N, Kajiwara S. Gastric liposarcoma resected by laparoscopic total gastrectomyto achieve a wide surgical margin. BMJ Case Rep. 2017. https://doi.org/10.1136/bcr-2017-221703
Joensu H. Risk stratification of patients diagnosed with gastrointestinal srtomal tumor. Human Pathol. 2008;41:1411-1419. https://doi.org/10.1016/j.humpath.2008.06.025
Miettinen M, Fetsch JF, Sobin LH, Lasota J. Gastrointestinal Stromal Tumors in Patients With Neurofibromatosis 1: A Clinicopathologic and Molecular Genetic Study of 45 Cases. Am J Surg Pathol. 2006;30(1):90-96. https://doi.org/10.1097/01.pas.0000176433.81079.bd
Kim SY, Kim KO. Management of gastric subepithelial tumors: The role of endoscopy. World J Gastrointest Endosc. 2016;8(11):418-424. https://doi.org/10.4253/wjge.v8.i11.418
Guo Y, Jing X, Zhang J, Ding X, Li X, Mao T, Tian Z. Endoscopic Removal of Gastrointestinal Stromal Tumors in the Stomach: A Single-Center Experience. Gastroenterol Res Pract. 2019;9(1):71-82. https://doi.org/10.1155/2019/3087298
Koizumi S, Kida M, Yamauchi H, Okuwaki K, Iwai T, Miyazawa S, Takezawa M, Imaizumi H., Koizumi W. Clinical implications of doubling time of gastrointestinalsubmucosal tumors. World J Gastroenterol. 2016;22(45):10015-10023. https://doi.org/10.3748/wjg.v22.i45.10015
Shen C, Chen H, Yin Y, Chen J, Han L, Zhang B, Chen Z, Chen J. Endoscopic versus open resection for small gastric gastrointestinal stromal tumors: safety and outcomes. Medicine (Baltimore). 2015;94(1):e376. https://doi.org/10.1097/md.0000000000000376
Koga T, Hirayama Y, Yoshiya S, Taketani K, Nakanoko T, Yoshida R, Minagawa R, Kai M, Kajiyama K, Akahoshi K, Maehara Y. Necessity for resection of gastric gastrointestinal stromal tumors ≤ 10 mm. Anticancer Res. 2015;35(4):1341-1344.
Xu HW, Zhao Q, Yu SX, Jiang Y, Hao JH, Li B. Comparison of different endoscopic resection techniques for submucosal tumors originating from muscularis propria at the esophagogastric junction. BMC Gastroenterol. 2019;19(1):174. https://doi.org/10.1186/s12876-019-1099-5
Chetta N, Martines G, Picciariello A, Capuano P. Successful Laparoscopic Sleeve Gastrectomy in Emergency for a Gastric Gastrointesti-nal Stomal Tumor (GIST) with Acute Bleeding: A Case Report. Am J Case Rep. 2018;19:849-53. https://doi.org/10.12659/ajcr.909798
Deesomsak M, Aswakul P, Junyangdikul P, Prachayakul V. Rare adult gastric duplication cyst mimicking a gastrointestinal stromal tumor. World J Gastroenterol. 2013;19(45):8445-8448. https://doi.org/10.3748/wjg.v19.i45.8445
Ichinose M, Hikichi T, Kanno Y, Gunji N, Fujita M, Kuroda M, Terashima K, Sato Y, Kawana S, Hashimoto Y, Ohira H, Miyata MA. Case of gastric lipoma resected by endoscopic submucosa dissection with difficulty in preoperative diagnosis. Fukushima J Med Sci. 2017;63(3):160-164. https://doi.org/10.5387/fms.2016-19
Sanei B, Kefayat A, Samadi M, Goli P, Sanei M.H., Khodadustan M. Gastric Schwannoma: A Case Report and Review of the Literature for Gastric Submucosal Masses Distinction. Case Rep Med. 2018;4:1-5. https://doi.org/10.1155/2018/1230285
Termos S, Reslan O, Alqabandi O, AlDuwaisan A, AlSubaie S, Alyatama K, Alali M, AlSaleh A. Giant gastric lipoma presenting as GI bleed: Enucleation or Resection? Int J Surg Case Rep. 2017;41:39-42. https://doi.org/10.1016/j.ijscr.2017.10.004
Zhou Y, Zhou S, Shi Y, Zheng S, Liu B. Endoscopic submucosal dissection for gastric ectopic pancreas: a single-center experience. World J Surg Oncol. 2019;17(69). https://doi.org/10.1186/s12957-019-1612-x
Nishida T, Goto O, Raut CP, Yahagi N. Diagnostic and treatment strategy for small gastrointestinal stromal tumors. Cancer. 2016;122(20):3110-3118. https://doi.org/10.1002/cncr.30239
Li L, Wang F, Wu B, Wang Q, Wang C, Liu J. Endoscopic submucosal dissection of gastric fundus subepithelial tumors originating from the muscularis propria. Exp Ther Med. 2013;6(2):39-395. https://doi.org/10.3892/etm.2013.1181
Huang ZG, Zhang XS, Huang SL, Yuan XG. Endoscopy dissection of small stromal tumors emerged from the muscularis propria in the upper gastrointestinal tract: Preliminary study. World J Gastrointest Endosc. 2012;4(12):565-570. https://doi.org/10.4253/wjge.v4.i12.565
Huang CM, Chen QF, Lin JX, Lin M, Zheng CH, Li P, Xie JW, Wang GB, Lu J, Chen QY, Cao LL, Tu RH. Can laparoscopic surgery be applied in gastric gastrointestinal stromal tumors located in unfavorable sites? A study based on the NCCN guidelines. Medicine (Baltimore). 2017;96(14):e6535. https://doi.org/10.1097/md.0000000000006535
Ko SY, Lee JS, Kim JJ, Park SM. Higher incidence of gastroesophageal reflux disease after gastric wedge resections of gastric submucosal tumors located close to the gastroesophageal junction. Ann Surg Treat Res. 2014;86(6):189-194. https://doi.org/10.4174/astr.2014.86.6.289
Shichijo S, Uedo N, Yanagimoto Y, Yamamoto K, Kono M, Fukuda H, Shimamoto Y, Nakagawa K, Ohmori M, Arao M, Iwatsubo M, Iwagami H, Inoue S, Matsuno K, Matsuura N, Nakahira H, Maekawa A, Kanesaka T, Takeuchi Y, Ishihara K, Ohmori T, Ishihara R. Endoscopic full-thickness resection of gastric gastrointestinal stromal tumor: a Japanese case series. Ann Gastroenterol. 2019;32(6):593-599. https://doi.org/10.20524/aog.2019.0413
Asaki S, Nishimura T, Ohara S, Sato A, Shibuya D, Kanazawa N, Goto Y. New trial of endoscopic treatment for gastric submucosal tumors. Tohoku J Exp Med. 1985;145(2):149-159. https://doi.org/10.1620/tjem.145.149
Ge N, Hu JL, Yang F, Yang F, Sun SY. Endoscopic full-thickness resection for treating small tumor soriginating from the muscularis propria in the gastric fundus: An improvement in technique over 15 years. World J Gastrointest Oncol. 2019;11(11):1054-1064. https://doi.org/10.4251/wjo.v11.i11.1054
Andalib I, Yeoun D, Reddy R, Xie S. Iqbal S. Endoscopic resection of gastric gastrointestinal stromal tumors originating from the muscularis propria layer in North America: methods and feasibility data. Surg Endosc. 2018;32(4):1787-1792. https://doi.org/10.1007/s00464-017-5862-9
Lu J, Jiao T, Li Y, Liu Y, Wang Y, Wang Y, Zheng M, Lu X. Heading toward the right direction-solution package for endoscopic submucosal tunneling resection in the stomach. PLoS One. 2015;10(3):e0119870. https://doi.org/10.1371/journal.pone.0119870
Zhang X, Modayil R, Criscitelli T, Stavropoulos SN. Endoscopic resection for subepithelial lesions-pure endoscopicfull-thickness resection and submucosal tunneling endoscopic resection. Transl Gastroenterol Hepatol. 2019;4:39. https://doi.org/10.21037/tgh.2019.05.01
Zhang Y, Mao X, Zhou X, Yang H, Zhu LH, Chen G, Ye LP. Long-term outcomes of endoscopic resection for small (≤4.0 cm) gastric gastrointestinal stromal tumors originating from the muscularis propria layer. World J Gastroenterol. 2018;24(27):3030-3037. https://doi.org/10.3748/wjg.v24.i27.3030
Zhang H, Huang X, Qu C, Bian C, Xue H. Comparison between endoscopic and laparoscopic removal of gastric submucosal tumor. Saudi J Gastroenterol. 2019;25(4):245-250. https://doi.org/10.4103/sjg.sjg_412_18
Yu C, Liao G, Fan C, Yu J, Nie X, Yang S, Bai J. Long-term outcomes of endoscopic resection of gastric GISTs. Surg Endosc. 2017; 31(11):4799-4804. https://doi.org/10.1007/s00464-017-5557-2
Starkov YuG, Solodinina EN, Dzhantukhanova SV, Vyborniy MI, Lukich KV, Zamolodchikov RD, Klassifikatsiya neepitelial’nyi opukholei verkhnikh otdelov zheludochno-kishechnogo trakta dlya vybora sposoba operativnogo vmeshatel’stva. Povolzhskii onkologicheskii vestnik. 2017;5(32):45-50. (In Russ.).
Bang CS, Baik GH, Shin IS, Suk KT, Yoon JH, Kim DJ. Endoscopic submucosal dissection of gastric subepithelial tumors: a systematic review and meta-analysis. Korean J Intern Med. 2016;31(5):860-871. https://doi.org/10.3904/kjim.2015.093
Zhang Y, Wang Z, Jin T, Li KQ, Hao K, Zhang W, Fei B. Hyperechoic demarcation line between a tumor and the muscularis propria layer as a marker for deciding the endoscopic treatment of gastric submucosal tumor. J Zhejiang Univ Sci B. 2017;18(8):707-716. https://doi.org/10.1631/jzus.b1600256
Aslanian HR Sethi A, Bhutani MS, Goodman AJ, Krishnan K, Lichtenstein DR, Melson J, Navaneethan U, Pannala R, Parsi MA, Schulman AR, Sullivan SA, Thosani N, Trikudanathan G, Trindade AJ, Watson RR, Maple JT. ASGE guideline for endoscopic full thickness resection and submucosal tunnel endoscopic resection. VideoGIE. 2019;4(8):343-350. https://doi.org/10.1016/j.vgie.2019.03.010
Dellatore P, Bhagat V, Kahaleh M. Endoscopic full thickness resection versus submucosal tunneling endoscopic resection for removal of submucosal tumors: a review article. Transl. Gastroenterol. Hepatol. 2019;4:829854. https://doi.org/10.21037/tgh.2019.05.03
Zhang Y, Ye LP, Mao XL. Endoscopic treatments for small gastric subepithelial tumors originating from muscularis propria layer. World J Gastroenterol. 2015;11(31):9503-9511. https://doi.org/10.3748/wjg.v21.i32.9503
Wu CR, Huang LY, Guo J, Zhang B, Cui J, Sun CM, Jiang LX, Wang ZH, Ju AH. Clinical Control Study of Endoscopic Full-thickness Resection and Laparoscopic Surgery in the Treatment of Gastric Tumors Arising from the Muscularis Propria. Chin Med J (Engl). 2015;128(11):1455-1459. https://doi.org/10.4103/0366-6999.157651
Mori H, Rahman A, Kobara H, Fujihara S, Nishiyama N, Ayaki M, Matsunaga T, Murakami M, Masaki T. Current Status of Exposed Endoscopic Full-Thickness Resection and Further Development of Non-Exposed Endoscopic Full-Thickness Resection. Digestion. 2017;95(1):6-15. https://doi.org/10.1159/000452352
Tang X, Ren Y, Huang S, Gao Q, Zhou J, Wei Z, Jiang B, Gong W. Endoscopic Submucosal Tunnel Dissection for Upper Gastrointestinal Submucosal Tumors Originating from the Muscularis Propria Layer: A Single-Center Study. Gut Liver. 2017;11(5):620-627. https://doi.org/10.5009/gnl15424
Du C, Chai NL, Ling-Hu EQ, Li ZJ, Li LS, Zou JL, Jiang L, Lu ZS, Meng JY, Tang P. Submucosal tunneling endoscopic resection: An effective and safe therapy for upper gastrointestinal submucosal tumors originating from the muscularis propria layer. World J Gastroenterol. 2019;25(2):245-257. https://doi.org/10.3748/wjg.v25.i2.245

Close metadata