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A novel technique for removing large gastric subepithelial tumors with ESD method in the subcardia region

  • Authors:
    • Bingtuan Liu
    • Han Chen
    • Weifeng Zhang
    • Guoxin Zhang

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  • Published online on: September 19, 2019     https://doi.org/10.3892/ol.2019.10894
  • Pages: 5277-5282

  • Copyright: © Liu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Previously, patients with tumors larger than 4 cm in sub-cardia region usually received open gastrectomy. Due to its anatomic features, the cardia is often considered as a contraindicated area for endoscopic resection. Herein, we report a novel technique of endoscopic submucosal dissection (ESD) which facilitates the removal of gastric subepithelial tumors (SMTs) larger than 4 cm in the subcardia and fundus region. This is a retrospective case series of patients with SMTs larger than 4 cm in the subcardia and fundus regions who received the novel procedure of ESD between October 2015 and October 2016. The novel procedure of ESD involved a median linear incision of the mucosa being made in the central area of the tumor, followed by the submucosal dissection. The residual defect was finally closed using titanium endoclips. The endoscopical outcomes, histopathological findings as well as other complications were assessed. Eight patients fulfilled the entry criteria. The mean lesion size was 45.6±7.5 mm (range: 40.0‑65.0 mm), and the mean operating time was 83±13 min (range: 60-100 min). The en bloc resection rate was 100%. Although perforations occurred in 5 out of 8 patients, they were successfully closed with endoclips. The median length of inpatient hospital stay was 6 days (range: 5-8 days). No patients needed further gastrectomy. The median follow‑up was 36 months and none of the patients developed local recurrence or distant metastasis. The advanced procedure of ESD is feasible and safe for tumors more than 4 cm in the subcardia region. It could be applied as a novel technique for treating patient without surgical interventions.
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November-2019
Volume 18 Issue 5

Print ISSN: 1792-1074
Online ISSN:1792-1082

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Spandidos Publications style
Liu B, Chen H, Zhang W and Zhang G: A novel technique for removing large gastric subepithelial tumors with ESD method in the subcardia region. Oncol Lett 18: 5277-5282, 2019.
APA
Liu, B., Chen, H., Zhang, W., & Zhang, G. (2019). A novel technique for removing large gastric subepithelial tumors with ESD method in the subcardia region. Oncology Letters, 18, 5277-5282. https://doi.org/10.3892/ol.2019.10894
MLA
Liu, B., Chen, H., Zhang, W., Zhang, G."A novel technique for removing large gastric subepithelial tumors with ESD method in the subcardia region". Oncology Letters 18.5 (2019): 5277-5282.
Chicago
Liu, B., Chen, H., Zhang, W., Zhang, G."A novel technique for removing large gastric subepithelial tumors with ESD method in the subcardia region". Oncology Letters 18, no. 5 (2019): 5277-5282. https://doi.org/10.3892/ol.2019.10894