Endoscopic Resection Of Gastric Submucosal Tumors Originating From The Muscularis Propria

【Objective】 To evaluate the efficacy and safety of endoscopic resection for gastric submucosal tumors originating from the muscularis propria.【Methods】105 patients with tumors originating from gastric muscularis propria confirmed by EUS were screened from all the patients undergoing ESD between January2010 and January 2012.The clinicopathological and postoperative followed-up data were analyzed.【Results 】There were 55 males and 50 females with the age ranging from 23 to 78years(mean,52.4 years).The maximum diameter of the lesions ranged from 8 to 40 mm(mean,17.6mm). Sixty-five patients underwent endoscopic submucosal excavation,forty patients underwent endoscopic full-thickness resection.The operative time ranged from 25 to 100 min,(mean,45.4minutes).In ESE group,62 out of 65(95.4%)cases were en bloc resected.Perforation occurred in 6 cases,all cases were successfully managed with metal clips;2 cases with unmanaged bleeding were performed surgery. 2 cases from ESE and EFR group each with delayed hemorrhage had endoscopic intervention and conservational therapy.Based on histopathological findings,50 cases of leiomyoma,48 of gastrointestinal stromal tumors,5 of ectopic pancreas,and 2 of neurilemmoma were diagnosed. 101 patients were accepted at least 36 months followed-up,and no local recurrence or distant metastasis occurred.【Conclusion】 Endoscopic resection is a effective and safe procedure for treating the tumors originating from gastric muscularis propria.