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Endoscopic laparoscopic gastric subepithelial tumor

Ryo Igarashi, Atsushi Irisawa, Goro Shibukawa, Nobutoshi Soeta, Ai Sato, Akane Yamabe, Mariko Fujisawa, Noriyuki Arakawa, Yoshitsugu Yoshida, Tsunehiko Ikeda, Yoko Abe, Takumi Maki, Shogo Yamamoto, Ikuro Oshibe, Takuro Saito, Hiroshi Hojo
Gastric neuroendocrine tumors (GNETs) are rare lesions characterized by enterochromaffin-like cells of the stomach. Optimal management of GNETs has not yet been definitively determined. Endoscopic resection is approximately recommended for small GNETs associated with hypergastrinemia. However, endoscopic resection might present risk of perforation or positive vertical margin because neuroendocrine tumors occur in the deep mucosa, with some invading the submucosa. In this case, a patient with type A chronic atrophic gastritis had a small subepithelial lesion in a deep submucosal layer, and we diagnosed it as GNET using endoscopic ultrasound-guided fine-needle aspiration biopsy using a forward-viewing and curved linear-array echoendoscope...
2018: Clinical Medicine Insights. Case Reports
Sun Gyo Lim, Hoon Hur, Sang-Uk Han, Kee Myung Lee, Joon Koo Kang, Sung Jae Shin, Yong Kwan Cho, Jin Hong Kim
OBJECTIVE: Laparoscopy-assisted endoscopic full-thickness resection (LAEFTR) has been suggested as an alternative to laparoscopic wedge resection in the treatment of gastric subepithelial tumors (SETs). It is expected to minimize the resection of the tissue surrounding the tumors and maintain the function of the remnant stomach. Here, we performed a prospective pilot study to evaluate the efficacy of laparoscopy-assisted endoscopic full-thickness resection (LAEFTR) for patients with gastric SETs...
March 2017: Scandinavian Journal of Gastroenterology
Osamu Goto, Hiroya Takeuchi, Motoki Sasaki, Hirofumi Kawakubo, Teppei Akimoto, Ai Fujimoto, Yasutoshi Ochiai, Tadateru Maehata, Toshihiro Nishizawa, Yuko Kitagawa, Naohisa Yahagi
Background and study aims: To avoid bacterial contamination and tumor seeding during gastrectomy surgery, we developed a nonexposure technique for endoscopic full-thickness resection with laparoscopic assistance. The feasibility and safety of nonexposed endoscopic wall-inversion surgery (NEWS) for gastric subepithelial tumors (SETs) were investigated. Patients and methods: For protruding gastric SETs ≤ 3 cm in diameter, NEWS was performed in the following sequence: laparoscopic seromuscular incision after endoscopic submucosal injection, laparoscopic seromuscular suturing with the lesion inverted, endoscopic mucosal and submucosal incision, and transoral retrieval...
November 2016: Endoscopy
Hyung Hun Kim, Noriya Uedo
Advances in laparoscopic surgery and therapeutic endoscopy have allowed these minimally destructive procedures to challenge conventional surgery. Because of its theoretic advantages and technical feasibility, laparoendoscopic full-thickness resection is considered to be the most appropriate option for subepithelial tumor removal. Furthermore, combination of laparoscopic and endoscopic approaches for treatment of neoplasia can be important maneuvers for gastric cancer resection without contamination of the peritoneal cavity if the sentinel lymph node concept is established...
April 2016: Gastrointestinal Endoscopy Clinics of North America
Osamu Goto, Hiroya Takeuchi, Yuko Kitagawa, Naohisa Yahagi
Endoscopic full-thickness resection for subepithelial tumors is one of the more attractive proposed methods for less-invasive transluminal surgery but remains challenging in terms of safety and feasibility. Currently, laparoscopic endoscopic cooperative surgery is thought to be a more clinically acceptable approach. In targeting cancers, however, more advanced nonexposure techniques are required to avoid the risk of iatrogenic tumor seeding. By combining these techniques with possible regional lymphadenectomy using sentinel node navigation surgery, an ideal minimally invasive, function-preserving gastric resection can be achieved even in possible node-positive cancers...
April 2016: Gastrointestinal Endoscopy Clinics of North America
Jaime Sampson Dávila, Dulce Momblán, Àngels Ginès, Cristina Sánchez-Montes, Isis Araujo, David Saavedra-Pérez, Antonio M Lacy, Gloria Fernández-Esparrach
BACKGROUND: Laparoscopic resection is considered the treatment of choice for gastric subepithelial tumors. Occasionally, it is necessary to perform an intraoperative gastroscopy to localize the lesion. There are no data in the literature addressing the factors that can predict when a combined laparoscopic-endoscopic approach will be needed. METHODS: A retrospective cohort study using a prospectively collected database was conducted. From January 2005 to December 2013, all the patients undergoing a laparoscopic gastric resection for subepithelial tumors irresectable by endoscopy were reviewed...
January 2016: Surgical Endoscopy
Kyung Hwa Yoon, Dong Yeub Eun, Jae Hoon Kim, Soo Ok Lee, Hyun Soo Kim, Dong Wook Lee
INTRODUCTION: Gastric adenomyoma is a rare benign tumor, known to occur in the antrum or pylorus of the stomach. To the best of our knowledge, this is the first case reported in the literature of a gastric adenomyoma in the stomach body, but not in the antrum. CASE PRESENTATION: We report the case of a 79-year-old Korean woman with a gastric subepithelial lesion in the stomach body. The lesion was observed via endoscopy as a bulging mass in the stomach body with a cystic center...
November 24, 2014: Journal of Medical Case Reports
Chang Min Lee, Hyung-Ho Kim
Minimally invasive surgery has become common in the surgical resection of gastrointestinal submucosal tumors (SMTs). The purpose of this article is to review recent trends in minimally invasive surgery for gastric SMTs. Although laparoscopic resection has been main stream of minimally invasive surgery for gastrointestinal SMTs, recent advances in endoscopic procedures now provide various treatment modalities for gastric SMTs. Moreover, investigators have developed several hybrid techniques that include the advantages of both laparoscopic and endoscopic procedure...
September 28, 2014: World Journal of Gastroenterology: WJG
Yosuke Minoda, Kazuya Akahoshi, Masafumi Oya, Masaru Kubokawa, Yasuaki Motomura, Kazuhiko Nakamura
A glomus tumor of the stomach is rare. It is difficult to diagnose the tumor before surgery by only endoscopic biopsy and radiography, and there is no established method of diagnosis before surgical treatment. Esophagogastroduodenoscopy (EGD) on a 50-year-old Japanese woman revealed a 10 mm submucosal tumor in the anterior wall of the gastric angle. Follow-up EGD revealed an increase in the size of the tumor to 15mm. Endoscopic ultrasonography (EUS) demonstrated a 15mm subepithelial hypoechoic solid tumor with continuity to the proper muscle layer...
April 2014: Fukuoka Igaku Zasshi, Hukuoka Acta Medica
Li-Ping Ye, Zhang Yu, Xin-Li Mao, Lin-hong Zhu, Xian-Bin Zhou
BACKGROUND AND AIMS: This retrospective study evaluated the safety and efficacy of endoscopic full-thickness resection (eFTR) with defect closure using clips and an endoloop for the treatment of gastric subepithelial tumors (SETs) arising from the muscularis propria (MP). METHODS: From January 2009 to December 2012, 51 patients with gastric SETs arising from the MP underwent eFTR with defect closure using clips and an endoloop. The key steps were (1) several milliliters of mixture solution was injected into the submucosa after dots were marked around the tumor; (2) a cross incision was made in the mucosa to reveal the tumor; (3) subsequently, circumferential excavation was performed as deep as the muscularis propria, and full-thickness resection of the tumor was performed with an insulated-tip knife, including its underlying MP and serosa; (4) the gastric wall defect was closed with clips and an endoloop was then placed to fix and tighten all of the clips together...
June 2014: Surgical Endoscopy
Lei Li, Feng Wang, Bo Wu, Qingcai Wang, Changhui Wang, Jiyong Liu
Endoscopic resection of gastric subepithelial tumors (SETs) carries a high risk of perforation, particularly for tumors located at the gastric fundus and originating from the muscularis propria. Based on our experience with endoscopic submucosal dissection (ESD) and a novel endoscopic device, namely the 'Resolution clip' for the endoscopic closure of iatrogenic upper gastrointestinal (upper GI) perforations, we evaluated the clinical feasibility and safety of ESD for gastric fundus subepithelial tumors originating from the muscularis propria...
August 2013: Experimental and Therapeutic Medicine
Jun Heo, Seong Woo Jeon
Diagnosis of gastric subepithelial tumor (SET) has shown a rapid increase worldwide. Although, until now, endoscopic ultrasound guided procedures such as fine needle aspiration have shown relatively high accuracy in diagnosis of SET, the most important modality for diagnosis and treatment of SETs is complete resection such as endoscopic or surgical resection. However, endoscopic resection or laparoscopic wedge resection alone also has some limitations. Endoscopic resection is difficult to perform in cases of gastric SET located within deep portion of the gastric layer or a relatively large (larger than 25 mm diameter)...
September 16, 2013: World Journal of Gastrointestinal Endoscopy
Daniel K Mullady, Benjamin R Tan
Management of patients with gastrointestinal stromal tumor (GIST) typically involves a combination of surgical, pathologic, and pharmacologic interventions. Gastroenterologists are often the first specialists to encounter patients presenting with GIST and are therefore responsible for facilitating early intervention strategies. Although patients with gastric or small-bowel GISTs typically present with symptoms, a diagnosis of GIST should be considered whenever a submucosal lesion is seen endoscopically. Visualization by standard endoscopy often can determine tumor location and size, although endoscopic ultrasound (EUS) is the most accurate imaging technique for submucosal lesions...
August 2013: Journal of Clinical Gastroenterology
Vincenzo Napolitano, Angelo M Pezzullo, Pio Zeppa, Pietro Schettino, Maria D'Armiento, Antonietta Palazzo, Cristina Della Pietra, Salvatore Napolitano, Giovanni Conzo
Gastric duplication cyst (GDC) with a pseudostratified columnar ciliated epithelium is an uncommon malformation supposed to originate from a respiratory diverticulum arising from the ventral foregut. Morphologic appearance of GDCs is variable, depending on the density of their contents. GDCs are often misdiagnosed as solid masses by imaging techniques, and as a consequence they may be wrongly overtreated. We report our case of a 56-year-old man with a 5 cm hypoechoic mass of the gastroesophageal junction, incidentally detected by transabdominal ultrasonography...
February 2, 2013: World Journal of Surgical Oncology
C Schlag, D Wilhelm, S von Delius, H Feussner, A Meining
BACKGROUND AND STUDY AIMS: Endoscopic resection of gastric subepithelial tumors (SETs) carries a high risk of perforation. New techniques such as use of the over-the-scope clip (OTSC) may enable secure endoscopic closure of perforations. We aimed to evaluate the feasibility of endoscopic resection of small gastric SETs using a grasp-and-snare technique followed by OTSC closure of the gastric wall if necessary. PATIENTS AND METHODS: In this prospective study 20 consecutive patients who presented with gastric SETs ≤ 3 cm were enrolled...
2013: Endoscopy
Xiu-Li Zhang, Jian-Hui Qu, Gang Sun, Ping Tang, Yun-Sheng Yang
BACKGROUND AND AIM: Gastric fundus perforation is a serious complication of endoscopic mucosal resection and endoscopic submucosal dissection performed for the removal of early gastric cancers or subepithelial tumors. The novel over-the-scope clip (OTSC) has recently been found to be effective for closing gastrointestinal-tract perforations and accesses for natural orifice transluminal endoscopic surgery. However, feasibility studies of OTSCs in gastric fundus perforation are still lacking...
July 2012: Journal of Gastroenterology and Hepatology
D Wilhelm, S von Delius, M Burian, A Schneider, E Frimberger, A Meining, H Feussner
BACKGROUND: Subepithelial gastric tumors are common findings during upper gastrointestinal endoscopy. Tumor resection is mostly done laparoscopically, but there is still discussion concerning the size of lesion for which the treatment may be minimally invasive; additionally there is very little data available concerning patient outcome after minor access surgery. METHODS: Clinicopathologic features and survival data of 93 consecutive patients undergoing a combined laparoscopic-endoscopic approach for gastric submucosal tumors were prospectively analyzed...
June 2008: World Journal of Surgery
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