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Endoscopic band ligation of small gastric stromal tumors and follow-up by endoscopic ultrasonography

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Abstract

Background

Gastrointestinal stromal tumor (GIST) is a relatively common gastric submucosal tumor with potential for malignant transformation. The efficacy of a new method for resection of these tumors, endoscopic band ligation, was evaluated.

Methods

The study included 29 patients with small gastric stromal tumors arising in the gastric muscularis propria as determined by endoscopy, endoscopic ultrasonography (EUS), and deep endoscopic biopsies. A standard endoscope with a transparent cap attached to the tip was used. The cap was placed over the lesion, maximum sustained suction was applied, and an elastic band was released around the base. Beginning two weeks after banding, the lesions were observed endoscopically once per week until healing was complete. Thereafter, all patients underwent EUS every two to three months on schedule.

Results

The 28 GISTs sloughed completely. The mean time required for complete healing after band ligation was 4.8 weeks. One lesion did not slough because they were not completely ligated. The lesion was ligated for the second time and sloughed completely. Bleeding occurred in one patient three days after ligation because the lesion sloughed early. The bleeding was managed successfully with metallic clips. No perforation and other complications occurred. Followup ranged from 36 to 51 months, during which time only one recurrence was observed four months postoperatively.

Conclusions

Endoscopic band ligation with systematic followup by EUS is an effective and safe treatment for small GISTs.

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References

  1. Binmoeller KF, Grimm H, Soehendra N (1993) Endoscopic closure of a perforation using metallic clips after snare excision of a gastric leiomyoma. Gastrointest Endosc 39: 172–174

    PubMed  CAS  Google Scholar 

  2. Catalano O, De Lutio Di Castelguidone E, Nunziata A, De Rosa V, Siani A (2005) Gastrointestinal stromal tumours: pictorial review. Radiol Med (Torino) 110(5–6): 484–491

    Google Scholar 

  3. Chang KJ, Yoshinaka R, Nguyen P (1996) Endoscopic ultrasound-assisted band ligation: a new technique for resection of submucosal tumors. Gastrointest Endosc 44: 720–722

    Article  PubMed  CAS  Google Scholar 

  4. Hepworth CC, Menzies D, Motson RW (2000) Minimally invasive surgery for posterior gastric stromal tumors. Surg Endosc 14: 349–353

    Article  PubMed  CAS  Google Scholar 

  5. Hindmarsh A, Koo B, Lewis MP, Rhodes M (2005) Laparoscopic resection of gastric gastrointestinal stromal tumors. Surg Endosc 19: 1109–1112

    Article  PubMed  CAS  Google Scholar 

  6. Hyung WJ, Lim JS, Cheong JH, Kim J, Choi SH, Noh SH (2005) Laparoscopic resection of a huge intraluminal gastric submucosal tumor located in the anterior wall: eversion method. J Surg Oncol 89(2): 95–98

    Article  PubMed  Google Scholar 

  7. Kitano S, Shiraishi N (2005) Minimally invasive surgery for gastric tumors. Surg Clin North Am 85(1): 151–164

    Article  PubMed  Google Scholar 

  8. Miettinen M, Kopczynski J, Makhlouf HR, Sarlomo-Rikala M, Gyorffy H, Burke A, Sobin LH, Lasota J (2003) Gastrointestinal stromal tumors, intramural leiomyomas, and leiomyosarcomas in the duodenum: a clinicopathologic, immunohistochemical, and molecular genetic study of 167 cases. Am J Surg Pathol. 27(5): 625–641

    Article  PubMed  Google Scholar 

  9. Nickl NJ (2004) Gastrointestinal stromal tumors: new progress, new questions. Curr Opin Gastroenterol 20(5): 482–487

    Article  PubMed  Google Scholar 

  10. Nowain A, Bhakta H, Pais S, Kanel G, Verma S (2005) Gastrointestinal stromal tumors: Clinical profile, pathogenesis, treatment strategies and prognosis. J Gastroenterol Hepatol 20(6): 818–824

    Article  PubMed  Google Scholar 

  11. Ozguc H, Yilmazlar T, Yerci O, Soylu R, Tumay V, Filiz G, Zorluoglu A (2005) Analysis of prognostic and immunohistochemical factors in gastrointestinal stromal tumors with malignant potential. J Gastrointest Surg 9(3): 418–429

    Article  PubMed  Google Scholar 

  12. Rothlin M, Schob O (2001) Laparoscopic wedge resection for benign gastric tumors. Surg Endosc 15(8): 893–895

    Article  PubMed  CAS  Google Scholar 

  13. Samiian L, Weaver M, Velanovich V (2004) Evaluation of gastrointestinal stromal tumors for recurrence rates and patterns of long-term follow-up. Am Surg 70(3): 187–191; discussion 191–192

    PubMed  Google Scholar 

  14. Sato T, Peiper M, Fritscher-Ravens A, Gocht A, Soehendra N, Knoefel WT (2005) Strategy of treatment of submucosal gastric tumors. Eur J Med Res 10(7): 292–295

    PubMed  CAS  Google Scholar 

  15. Sun S, Wang M, Sun S (2002) Use of endoscopic ultrasound-guided injection in endoscopic resection of solid submucosal tumors. Endoscopy 34: 82–85

    Article  PubMed  CAS  Google Scholar 

  16. Sun S, Jin Y, Chang G, Wang C, Li X, Wang Z (2004) Endoscopic band ligation without electrosurgery: a new technique for excision of small upper-GI leiomyoma. Gastrointest Endosc 60(2): 218–222

    Article  PubMed  Google Scholar 

  17. Wolfsohn DM, Savides TJ, Easter DW, Lyche KD (1997) Laparoscopy-assisted endoscopic removal of a stromal-cell tumor of the stomach. Endoscopy 29: 679–682

    PubMed  CAS  Google Scholar 

  18. Yu JP, Luo HS, Wang XZ (1992) Endoscopic treatment of submucosal lesions of the gastrointestinal tract. Endoscopy 24: 190–193

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Endoscopy Center, The Second Hospital, China Medical University, Sanhao Street 36, Shenyang, Liaoning Province, 110004, China

    Siyu Sun, Nan Ge, Caixia Wang & Mengchun Wang

  2. Pathology Department, The Second Hospital, China Medical University, Sanhao Street 36, Shenyang, Liaoning Province, 110004, China

    Qingjie Lü

Authors
  1. Siyu Sun
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  2. Nan Ge
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  3. Caixia Wang
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  4. Mengchun Wang
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  5. Qingjie Lü
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Correspondence to Siyu Sun.

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Sun, S., Ge, N., Wang, C. et al. Endoscopic band ligation of small gastric stromal tumors and follow-up by endoscopic ultrasonography. Surg Endosc 21, 574–578 (2007). https://doi.org/10.1007/s00464-006-9028-4

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  • DOI: https://doi.org/10.1007/s00464-006-9028-4

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