Tags

Type your tag names separated by a space and hit enter

Submucosal tumors of the esophagogastric junction originating from the muscularis propria layer: a large study of endoscopic submucosal dissection (with video).
Gastrointest Endosc 2012; 75(6):1153-8GE

Abstract

BACKGROUND

Given the high morbidity and mortality rates for surgery and the diminishment of quality of life caused by operative resection of the gastric cardia, a minor invasive treatment without loss of curability is desirable for submucosal tumors (SMTs) of the esophagogastric junction (EGJ). Endoscopic submucosal dissection (ESD) has been used successfully for the removal of esophageal or gastric SMTs; however, the EGJ has been regarded as a difficult location for ESD because of its narrow lumen and sharp angle.

OBJECTIVE

To evaluate the clinical impact of ESD for SMTs of the EGJ arising from the muscularis propria layer.

DESIGN

Single-center, prospective study.

SETTING

Academic medical center.

PATIENTS

143 patients with 143 SMTs of the EGJ originating from the muscularis propria layer.

INTERVENTIONS

ESD.

MAIN OUTCOME MEASUREMENTS

Complications, en bloc resection rate, local recurrence, and distant metastases.

RESULTS

The average maximum diameter of the lesions was 17.6 mm (range 5 - 50 mm). The en bloc resection rate was 94.4% (135/143). All en bloc resection lesions showed both lateral and deep tumor-free margins, including 20 GI stromal tumors. Perforations occurred in 6 patients (4.2%, 6/143), and metal clips were used to occlude the defect. Four pneumoperitoneum and 2 pneumothorax caused by perforations were resolved with nonsurgical treatment. Local recurrence and distant metastasis have not occurred during a 2-year follow-up.

LIMITATIONS

Single-center, short follow-up.

CONCLUSIONS

ESD appears to be a safe, feasible, and effective procedure for providing accurate histopathologic evaluations, as well as curative treatments for SMTs of the EGJ originating from the muscularis propria layer.

Authors+Show Affiliations

Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Video-Audio Media

Language

eng

PubMed ID

22459663

Citation

Li, Quan-Lin, et al. "Submucosal Tumors of the Esophagogastric Junction Originating From the Muscularis Propria Layer: a Large Study of Endoscopic Submucosal Dissection (with Video)." Gastrointestinal Endoscopy, vol. 75, no. 6, 2012, pp. 1153-8.
Li QL, Yao LQ, Zhou PH, et al. Submucosal tumors of the esophagogastric junction originating from the muscularis propria layer: a large study of endoscopic submucosal dissection (with video). Gastrointest Endosc. 2012;75(6):1153-8.
Li, Q. L., Yao, L. Q., Zhou, P. H., Xu, M. D., Chen, S. Y., Zhong, Y. S., ... Qin, W. Z. (2012). Submucosal tumors of the esophagogastric junction originating from the muscularis propria layer: a large study of endoscopic submucosal dissection (with video). Gastrointestinal Endoscopy, 75(6), pp. 1153-8. doi:10.1016/j.gie.2012.01.037.
Li QL, et al. Submucosal Tumors of the Esophagogastric Junction Originating From the Muscularis Propria Layer: a Large Study of Endoscopic Submucosal Dissection (with Video). Gastrointest Endosc. 2012;75(6):1153-8. PubMed PMID: 22459663.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Submucosal tumors of the esophagogastric junction originating from the muscularis propria layer: a large study of endoscopic submucosal dissection (with video). AU - Li,Quan-Lin, AU - Yao,Li-Qing, AU - Zhou,Ping-Hong, AU - Xu,Mei-Dong, AU - Chen,Shi-Yao, AU - Zhong,Yun-Shi, AU - Zhang,Yi-Qun, AU - Chen,Wei-Feng, AU - Ma,Li-Li, AU - Qin,Wen-Zheng, Y1 - 2012/03/28/ PY - 2011/10/15/received PY - 2012/01/18/accepted PY - 2012/3/31/entrez PY - 2012/3/31/pubmed PY - 2012/11/9/medline SP - 1153 EP - 8 JF - Gastrointestinal endoscopy JO - Gastrointest. Endosc. VL - 75 IS - 6 N2 - BACKGROUND: Given the high morbidity and mortality rates for surgery and the diminishment of quality of life caused by operative resection of the gastric cardia, a minor invasive treatment without loss of curability is desirable for submucosal tumors (SMTs) of the esophagogastric junction (EGJ). Endoscopic submucosal dissection (ESD) has been used successfully for the removal of esophageal or gastric SMTs; however, the EGJ has been regarded as a difficult location for ESD because of its narrow lumen and sharp angle. OBJECTIVE: To evaluate the clinical impact of ESD for SMTs of the EGJ arising from the muscularis propria layer. DESIGN: Single-center, prospective study. SETTING: Academic medical center. PATIENTS: 143 patients with 143 SMTs of the EGJ originating from the muscularis propria layer. INTERVENTIONS: ESD. MAIN OUTCOME MEASUREMENTS: Complications, en bloc resection rate, local recurrence, and distant metastases. RESULTS: The average maximum diameter of the lesions was 17.6 mm (range 5 - 50 mm). The en bloc resection rate was 94.4% (135/143). All en bloc resection lesions showed both lateral and deep tumor-free margins, including 20 GI stromal tumors. Perforations occurred in 6 patients (4.2%, 6/143), and metal clips were used to occlude the defect. Four pneumoperitoneum and 2 pneumothorax caused by perforations were resolved with nonsurgical treatment. Local recurrence and distant metastasis have not occurred during a 2-year follow-up. LIMITATIONS: Single-center, short follow-up. CONCLUSIONS: ESD appears to be a safe, feasible, and effective procedure for providing accurate histopathologic evaluations, as well as curative treatments for SMTs of the EGJ originating from the muscularis propria layer. SN - 1097-6779 UR - https://www.unboundmedicine.com/medline/citation/22459663/Submucosal_tumors_of_the_esophagogastric_junction_originating_from_the_muscularis_propria_layer:_a_large_study_of_endoscopic_submucosal_dissection__with_video__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(12)00096-X DB - PRIME DP - Unbound Medicine ER -