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Choice of the method of endoscopic resection of subepithelial gastric tumors

https://doi.org/10.17238/2072-3180-2023-1-64-72

Abstract

Introduction. The introduction of endoscopic intraluminal technologies is one of the current trends in the surgical treatment of patients with gastric subepithelial lesions. The number of publications showing the success of endoscopic operations is growing. Despite this and due to the variable characteristics of these tumors, there is no single algorithm for choosing a technique. 

Aim. To improve the results of treatment of patients with subepithelial lesions of the stomach.

Materials and methods. We retrospectively analysed 74 patients with subepithelial lesions who underwent different endoscopic surgeries in our hospital from 2013 to 2022. 27 patients underwent endoscopic dissections in the submucosal layer, 34 tunnel dissections, 10 endoscopic muscle dissections and 3 full-thickness resections.

Results. All surgical interventions were performed as planned. No intra- and postoperative complications requiring changes in therapeutic setting occurred. Carboxyperitoneum was detected in 17 patients (50%) who underwent tunnel intervention. Only 8 cases (23,5%) required decompression of the abdominal cavity using a Veress needle. Upper GI endoscopy and CT of the chest and abdominal cavity were performed at 6 and 12 months. No recurrence was observed.

Conclusion. The developed algorithm for choosing a technique of gastric subepithelial lesions endoscopic removal allows to gain the correct access to the tumor. As a result of the operation can be performed with minimal time costs and risks of complications. Rapid rehabilitation is an undoubted advantage of endoscopic interventions.

About the Authors

I. I. Khvorova
A.S. Loginov Moscow Clinical Research Center, Healthcare Department
Russian Federation

Khvorova Irina Igorevna – endoscopist of department of endoscopy

86, Shosse Entuziastov, Moscow, 111123



K. V. Shishin
A.S. Loginov Moscow Clinical Research Center, Healthcare Department
Russian Federation

Shishin Kirill Vyacheslavovich – doctor of Medical Sciences, Professor, head of department of endoscopy

86, Shosse Entuziastov, Moscow, 111123



I. Yu. Nedoluzhko
A.S. Loginov Moscow Clinical Research Center, Healthcare Department
Russian Federation

Nedoluzhko Ivan Yurievich – candidate of Medical Sciences, head of department of Operative Endoscopy

86, Shosse Entuziastov, Moscow, 111123



L. V. Shumkina
A.S. Loginov Moscow Clinical Research Center, Healthcare Department
Russian Federation

Shumkina Lada Vyacheslavovna – candidate of Medical Sciences, researcher of department of Operative Endoscopy

86, Shosse Entuziastov, Moscow, 111123



N. A. Kurushkina
A.S. Loginov Moscow Clinical Research Center, Healthcare Department
Russian Federation

Kurushkina Natalya Andreevna – candidate of Medical Sciences, researcher of department of Operative Endoscopy

86, Shosse Entuziastov, Moscow, 111123



References

1. Kubota A., Kuwabara S., Yamaguchi K., Kobayashi K., Hashidate H. Gastrointestinal stromal tumor of the stomach with lymph node metastasis treated by laparoscopic and endoscopic cooperative surgery with lymph node pick-up resection: A case report and literature review. Int. J Surg. Case Rep., 2020, № 77, pp. 178–181. https://doi.org/10.1016/j.ijscr.2020.10.131

2. Buldanlı M. Z., Yener O. Endoscopic Resection of Upper Gastrointestinal Subepithelial Tumours: Our Clinical Experience and Results. Prague Med Rep., 2022, № 123(1), pp. 20–26. https://doi:10.14712/23362936.2022.2

3. Chen H., Li B., Li L., Vachaparambil C.T., Lamm V., Chu Y., Xu M., Cai Q. Current Status of Endoscopic Resection of Gastric Subepithelial Tumors. Am J Gastroenterol., 2019, № 114(5), pp.718–715. https://doi.org/10.14309/ajg.0000000000000196

4. Chen Q., Yu M., Lei Y., Zhong C., Liu Zh., Zhou X. , Li G. , Zhou X., Chen Y. Efficacy and safety of endoscopic submucosal dissection for large gastric stromal tumors. Clin. Res. Hepatol Gastroenterol., 2020, № 44(1), pp. 90–100. https://doi.org/10.1016/j.clinre.2019.03.004

5. Granata A., Martino A., Amata M., Ligresti D., Tuzzolino F., Traina M. Efficacy and safety of gastric exposed endoscopic full-thickness resection without laparoscopic assistance: a systematic review. Endosc. Int. Open., 2020, № 8(9), pp. E1173–E1182. https://doi.org/10.1055/a-1198-4357

6. Goto, E., Koizumi, K. Higuchi, H., Noda, T., Onda , J., Omori J., Kaise M., Iwakiri K. Cutting-Edge Technologies for Gastrointestinal Therapeutic Endoscopy. J Nippon Med. Sch., 2021, № 88(1), pp. 17–24. https://doi:10.1272/jnms.JNMS.2021_88-109

7. Granata A., Martino A., Amata M., Ligresti D., Traina M. Gastrointestinal exposed endoscopic full-thickness resection in the era of endoscopic suturing: a retrospective single-center case series. Wideochir Inne Tech Maloinwazyjne, 2021, № 16(2), pp. 321–328. https://doi.org/10.5114/wiitm.2021.104496

8. Nabi, Z., Reddy D. N., Ramchandani M. Recent Advances in ThirdSpace Endoscopy. Gastroenterol Hepatol (N Y), 2018, 14(4), pp. 224–232.

9. Santos-Antunes J., Marques M., Morais R., Baldaque-Silva F.,VilasBoas F., Moutinho-Ribeiro P., Lopes S., Carneiro F., Macedo G. Retrospective analysis of the outcomes of endoscopic submucosal dissection for the diagnosis and treatment of subepithelial lesions in a center with high expertise. Ann Gastroenterol., 2022, № 35(1), pp. 68–73. https://doi.org/10.20524/aog.2021.0675

10. Dellatore P., V. Bhagat, Kahaleh M. Endoscopic full thickness resection versus submucosal tunneling endoscopic resection for removal of submucosal tumors: a review article. Transl. Gastroenterol. Hepatol., 2019, № 4, pp. 829–854. https://doi.org/10.21037/tgh.2019.05.03

11. Abe S., Wu S., Ego M., Takamaru H., Sekiguchi M., Yamada M., Nonaka S., Sakamoto T., Suzuki H. , Yoshinaga Sh., Matsuda T., Oda I., Saito Y. Efficacy of Current Traction Techniques for Endoscopic Submucosal Dissection. Gut. Liver., 2020, № 14(6), pp. 673–684. https://doi.org/10.5009/gnl19266

12. Chang J. , Kim T. J., Hwang N. Y., Sohn I., Min Y. W., Lee H., Min B. H., Lee J. H., Rhee P., Kim J. J. Clinical Outcomes and Adverse Events of Gastric Endoscopic Submucosal Dissection of the Mid to Upper Stomach under General Anesthesia and Monitored Anesthetic Care. Clin. Endosc., 2022, № 55(1), pp. 77–85. https://doi.org/10.5946/ce.2021.002

13. Liu S., Zhou X., Yao Y., Shi K., Yu M., Ji F. Resection of the gastric submucosal tumor (G-SMT) originating from the muscularis propria layer: comparison of efficacy, patients’ tolerability, and clinical outcomes between endoscopic full-thickness resection and surgical resection. Surg. Endosc., 2020, № 34(9), pp. 4053–4064. https://doi.org/10.1007/s00464-019-07311-x

14. Starkov Yu. G., Solodinina E. N., Dzhantukhanova S. V., Vyborniy M.I., Lukich K.V., Zamolodchikov R.D., Klassifikatsiya neepitelial’nyi opukholei verkhnikh otdelov zheludochno-kishechnogo trakta dlya vybora sposoba operativnogo vmeshatel’stva. Povolzhskii onkologicheskii vestnik, 2017, № 5 (32). (In Russ.). УДК 616.33/.342-006-035-08

15. Guo J.T., Zhang J. J., Wu Y. F., Liao Y., Wang Y. D., Zhang B. Zh., Wang Sh., Sun S. Y. Endoscopic full-thickness resection using an over-the-scope device: A prospective study. World J Gastroenterol., 2021, № 27(8), pp. 725–736. https://doi.org/10.3748/wjg.v27.i8.725


Review

For citations:


Khvorova I.I., Shishin K.V., Nedoluzhko I.Yu., Shumkina L.V., Kurushkina N.A. Choice of the method of endoscopic resection of subepithelial gastric tumors. Moscow Surgical Journal. 2023;(1):64-72. (In Russ.) https://doi.org/10.17238/2072-3180-2023-1-64-72

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ISSN 2072-3180 (Print)