Heading toward the right direction--solution package for endoscopic submucosal tunneling resection in the stomach
The emerging submucosal tunneling and endoscopic resection (STER) technique provides definitive histological diagnosis as well as a therapeutic method for the gastric submucosal tumors (SMTs). We aim to present our experience and discuss key technical issues of STER. 45 patients with gastric SMTs ar...
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| description | The emerging submucosal tunneling and endoscopic resection (STER) technique provides definitive histological diagnosis as well as a therapeutic method for the gastric submucosal tumors (SMTs). We aim to present our experience and discuss key technical issues of STER.
45 patients with gastric SMTs arising from MP received STER. First, a mucosal incision was made 3 cm proximal to the tumour, a submucosal tunnel was subsequently built from the incision to the tumor. The tumor was gradually exposed and dissected from surrounding tissue and retrieved from the tunnel. The initial mucosal incision was closed by metal clips. For SMTs in the gastric fundus near cardia, the submucosal tunnel was built from lower esophagus, through the angle of His, to the tumor for resection.
STER was successfully performed in 43 patients; the other two were converted to surgery. Mean operating time was 79.3 min (range 45-150 min). Mean tumor size was 1.4 cm (range 0.5-5 cm). Of the total 47 resected SMTs, 36 were GISTs, 10 were leiomyomas and 1 was schwannoma. Complete resection was achieved in all patients. Intra-procedural peumoperitoneum occurred in 3 cases because of iatrogenic perforation, no special treatment was given. 7 patients presented with mild abdominal pain/distention and fever were given antibotics. No severe post-operative complication happened. No tumor recurrence occurred in the median 11 month follow-up period.
Based on short-term follow-up observation, STER is a feasible, safe and minimally invasive method for the diagnosis and treatment of small ( |
| doi_str_mv | 10.1371/journal.pone.0119870 |
| format | Article |
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45 patients with gastric SMTs arising from MP received STER. First, a mucosal incision was made 3 cm proximal to the tumour, a submucosal tunnel was subsequently built from the incision to the tumor. The tumor was gradually exposed and dissected from surrounding tissue and retrieved from the tunnel. The initial mucosal incision was closed by metal clips. For SMTs in the gastric fundus near cardia, the submucosal tunnel was built from lower esophagus, through the angle of His, to the tumor for resection.
STER was successfully performed in 43 patients; the other two were converted to surgery. Mean operating time was 79.3 min (range 45-150 min). Mean tumor size was 1.4 cm (range 0.5-5 cm). Of the total 47 resected SMTs, 36 were GISTs, 10 were leiomyomas and 1 was schwannoma. Complete resection was achieved in all patients. Intra-procedural peumoperitoneum occurred in 3 cases because of iatrogenic perforation, no special treatment was given. 7 patients presented with mild abdominal pain/distention and fever were given antibotics. No severe post-operative complication happened. No tumor recurrence occurred in the median 11 month follow-up period.
Based on short-term follow-up observation, STER is a feasible, safe and minimally invasive method for the diagnosis and treatment of small (<3 cm) SMTs in gastric body, antrum and proximal cardia.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0119870</identifier><identifier>PMID: 25799065</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Aged ; Biopsy ; Cardia - pathology ; Cardia - surgery ; Chronic obstructive pulmonary disease ; Diagnosis ; Dissection ; Endoscopes ; Endoscopy ; Endoscopy, Gastrointestinal ; Esophagus ; Female ; Fever ; Fibroids ; Follow-Up Studies ; Gastrectomy ; Gastric cancer ; Gastric Fundus - pathology ; Gastric Mucosa - pathology ; Gastric Mucosa - surgery ; Gastroenterology ; Gastroscopy - methods ; Health aspects ; Hospitals ; Humans ; Laparoscopy ; Male ; Medicine ; Middle Aged ; Mucosa ; Neoplasm Staging ; Ostomy ; Pain ; Patients ; Perforation ; Political aspects ; Postoperative Complications ; Prognosis ; Retrospective Studies ; Schwann cells ; Stomach ; Stomach Neoplasms - pathology ; Stomach Neoplasms - surgery ; Surgery ; Tumors ; Tunneling ; Ultrasonic imaging</subject><ispartof>PloS one, 2015-03, Vol.10 (3), p.e0119870-e0119870</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Lu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Lu et al 2015 Lu et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-c1686f3dfd5e991204d6c3ffe6dd4c7d3846755ac8456e88624b2bcea68fc05b3</citedby><cites>FETCH-LOGICAL-c692t-c1686f3dfd5e991204d6c3ffe6dd4c7d3846755ac8456e88624b2bcea68fc05b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4370817/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4370817/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25799065$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Katoh, Masaru</contributor><creatorcontrib>Lu, Jiaoyang</creatorcontrib><creatorcontrib>Jiao, Taotao</creatorcontrib><creatorcontrib>Li, Yanmei</creatorcontrib><creatorcontrib>Liu, Ying</creatorcontrib><creatorcontrib>Wang, Yanan</creatorcontrib><creatorcontrib>Wang, Yatian</creatorcontrib><creatorcontrib>Zheng, Minhua</creatorcontrib><creatorcontrib>Lu, Xuefeng</creatorcontrib><title>Heading toward the right direction--solution package for endoscopic submucosal tunneling resection in the stomach</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The emerging submucosal tunneling and endoscopic resection (STER) technique provides definitive histological diagnosis as well as a therapeutic method for the gastric submucosal tumors (SMTs). We aim to present our experience and discuss key technical issues of STER.
45 patients with gastric SMTs arising from MP received STER. First, a mucosal incision was made 3 cm proximal to the tumour, a submucosal tunnel was subsequently built from the incision to the tumor. The tumor was gradually exposed and dissected from surrounding tissue and retrieved from the tunnel. The initial mucosal incision was closed by metal clips. For SMTs in the gastric fundus near cardia, the submucosal tunnel was built from lower esophagus, through the angle of His, to the tumor for resection.
STER was successfully performed in 43 patients; the other two were converted to surgery. Mean operating time was 79.3 min (range 45-150 min). Mean tumor size was 1.4 cm (range 0.5-5 cm). Of the total 47 resected SMTs, 36 were GISTs, 10 were leiomyomas and 1 was schwannoma. Complete resection was achieved in all patients. Intra-procedural peumoperitoneum occurred in 3 cases because of iatrogenic perforation, no special treatment was given. 7 patients presented with mild abdominal pain/distention and fever were given antibotics. No severe post-operative complication happened. No tumor recurrence occurred in the median 11 month follow-up period.
Based on short-term follow-up observation, STER is a feasible, safe and minimally invasive method for the diagnosis and treatment of small (<3 cm) SMTs in gastric body, antrum and proximal cardia.</description><subject>Adult</subject><subject>Aged</subject><subject>Biopsy</subject><subject>Cardia - pathology</subject><subject>Cardia - surgery</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Diagnosis</subject><subject>Dissection</subject><subject>Endoscopes</subject><subject>Endoscopy</subject><subject>Endoscopy, Gastrointestinal</subject><subject>Esophagus</subject><subject>Female</subject><subject>Fever</subject><subject>Fibroids</subject><subject>Follow-Up Studies</subject><subject>Gastrectomy</subject><subject>Gastric cancer</subject><subject>Gastric Fundus - pathology</subject><subject>Gastric Mucosa - pathology</subject><subject>Gastric Mucosa - surgery</subject><subject>Gastroenterology</subject><subject>Gastroscopy - methods</subject><subject>Health aspects</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Male</subject><subject>Medicine</subject><subject>Middle Aged</subject><subject>Mucosa</subject><subject>Neoplasm Staging</subject><subject>Ostomy</subject><subject>Pain</subject><subject>Patients</subject><subject>Perforation</subject><subject>Political aspects</subject><subject>Postoperative Complications</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Schwann cells</subject><subject>Stomach</subject><subject>Stomach Neoplasms - pathology</subject><subject>Stomach Neoplasms - surgery</subject><subject>Surgery</subject><subject>Tumors</subject><subject>Tunneling</subject><subject>Ultrasonic imaging</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk12L1DAUhoso7rr6D0QLguhFx3w1TW-EZVF3YGHBr9uQJmmbtZPMJqkf_950prNMZS8kFwnJ87455yQny55DsIK4gu9u3OitGFZbZ_UKQFizCjzITmGNUUERwA-P1ifZkxBuACgxo_RxdoLKqq4BLU-z20stlLFdHt0v4VUee5170_UxV8ZrGY2zRRHcME6rfCvkD9HpvHU-11a5IN3WyDyMzWaULoghj6O1epgMvQ57fW7szjZEtxGyf5o9asUQ9LN5Psu-ffzw9eKyuLr-tL44vyokrVEsJKSMtli1qtR1DREgikrctpoqRWSlMCO0KkshGSmpZowi0qBGakFZK0HZ4LPs5d53O7jA52oFDimtIAMMw0Ss94Ry4oZvvdkI_4c7Yfhuw_mOCx-NHDQvJUKMYCFUDQiuFcOlYm1FlAJNAxFJXu_n21IttJLaRi-GhenyxJqed-4nJ7gCDFbJ4M1s4N3tqEPkGxOkHgZhtRt3cdMKEUanuF_9g96f3Ux1IiVgbOvSvXIy5ecEoZIwTECiVvdQaSi9MTJ9rdak_YXg7UKQmKh_x06MIfD1l8__z15_X7Kvj9heiyH2h38XliDZg9K7ELxu74oMAZ8641ANPnUGnzsjyV4cP9Cd6NAK-C8jgApU</recordid><startdate>20150323</startdate><enddate>20150323</enddate><creator>Lu, Jiaoyang</creator><creator>Jiao, Taotao</creator><creator>Li, Yanmei</creator><creator>Liu, Ying</creator><creator>Wang, Yanan</creator><creator>Wang, Yatian</creator><creator>Zheng, Minhua</creator><creator>Lu, Xuefeng</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20150323</creationdate><title>Heading toward the right direction--solution package for endoscopic submucosal tunneling resection in the stomach</title><author>Lu, Jiaoyang ; Jiao, Taotao ; Li, Yanmei ; Liu, Ying ; Wang, Yanan ; Wang, Yatian ; Zheng, Minhua ; Lu, Xuefeng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-c1686f3dfd5e991204d6c3ffe6dd4c7d3846755ac8456e88624b2bcea68fc05b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biopsy</topic><topic>Cardia - pathology</topic><topic>Cardia - surgery</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Diagnosis</topic><topic>Dissection</topic><topic>Endoscopes</topic><topic>Endoscopy</topic><topic>Endoscopy, Gastrointestinal</topic><topic>Esophagus</topic><topic>Female</topic><topic>Fever</topic><topic>Fibroids</topic><topic>Follow-Up Studies</topic><topic>Gastrectomy</topic><topic>Gastric cancer</topic><topic>Gastric Fundus - pathology</topic><topic>Gastric Mucosa - pathology</topic><topic>Gastric Mucosa - surgery</topic><topic>Gastroenterology</topic><topic>Gastroscopy - methods</topic><topic>Health aspects</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Male</topic><topic>Medicine</topic><topic>Middle Aged</topic><topic>Mucosa</topic><topic>Neoplasm Staging</topic><topic>Ostomy</topic><topic>Pain</topic><topic>Patients</topic><topic>Perforation</topic><topic>Political aspects</topic><topic>Postoperative Complications</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Schwann cells</topic><topic>Stomach</topic><topic>Stomach Neoplasms - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lu, Jiaoyang</au><au>Jiao, Taotao</au><au>Li, Yanmei</au><au>Liu, Ying</au><au>Wang, Yanan</au><au>Wang, Yatian</au><au>Zheng, Minhua</au><au>Lu, Xuefeng</au><au>Katoh, Masaru</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Heading toward the right direction--solution package for endoscopic submucosal tunneling resection in the stomach</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-03-23</date><risdate>2015</risdate><volume>10</volume><issue>3</issue><spage>e0119870</spage><epage>e0119870</epage><pages>e0119870-e0119870</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The emerging submucosal tunneling and endoscopic resection (STER) technique provides definitive histological diagnosis as well as a therapeutic method for the gastric submucosal tumors (SMTs). We aim to present our experience and discuss key technical issues of STER.
45 patients with gastric SMTs arising from MP received STER. First, a mucosal incision was made 3 cm proximal to the tumour, a submucosal tunnel was subsequently built from the incision to the tumor. The tumor was gradually exposed and dissected from surrounding tissue and retrieved from the tunnel. The initial mucosal incision was closed by metal clips. For SMTs in the gastric fundus near cardia, the submucosal tunnel was built from lower esophagus, through the angle of His, to the tumor for resection.
STER was successfully performed in 43 patients; the other two were converted to surgery. Mean operating time was 79.3 min (range 45-150 min). Mean tumor size was 1.4 cm (range 0.5-5 cm). Of the total 47 resected SMTs, 36 were GISTs, 10 were leiomyomas and 1 was schwannoma. Complete resection was achieved in all patients. Intra-procedural peumoperitoneum occurred in 3 cases because of iatrogenic perforation, no special treatment was given. 7 patients presented with mild abdominal pain/distention and fever were given antibotics. No severe post-operative complication happened. No tumor recurrence occurred in the median 11 month follow-up period.
Based on short-term follow-up observation, STER is a feasible, safe and minimally invasive method for the diagnosis and treatment of small (<3 cm) SMTs in gastric body, antrum and proximal cardia.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>25799065</pmid><doi>10.1371/journal.pone.0119870</doi><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2015-03, Vol.10 (3), p.e0119870-e0119870 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1667180831 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS) Journals Open Access; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adult Aged Biopsy Cardia - pathology Cardia - surgery Chronic obstructive pulmonary disease Diagnosis Dissection Endoscopes Endoscopy Endoscopy, Gastrointestinal Esophagus Female Fever Fibroids Follow-Up Studies Gastrectomy Gastric cancer Gastric Fundus - pathology Gastric Mucosa - pathology Gastric Mucosa - surgery Gastroenterology Gastroscopy - methods Health aspects Hospitals Humans Laparoscopy Male Medicine Middle Aged Mucosa Neoplasm Staging Ostomy Pain Patients Perforation Political aspects Postoperative Complications Prognosis Retrospective Studies Schwann cells Stomach Stomach Neoplasms - pathology Stomach Neoplasms - surgery Surgery Tumors Tunneling Ultrasonic imaging |
| title | Heading toward the right direction--solution package for endoscopic submucosal tunneling resection in the stomach |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-19T20%3A48%3A46IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Heading%20toward%20the%20right%20direction--solution%20package%20for%20endoscopic%20submucosal%20tunneling%20resection%20in%20the%20stomach&rft.jtitle=PloS%20one&rft.au=Lu,%20Jiaoyang&rft.date=2015-03-23&rft.volume=10&rft.issue=3&rft.spage=e0119870&rft.epage=e0119870&rft.pages=e0119870-e0119870&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0119870&rft_dat=%3Cgale_plos_%3EA422548340%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1667180831&rft_id=info:pmid/25799065&rft_galeid=A422548340&rft_doaj_id=oai_doaj_org_article_5c22843aad90439d835d8f74dd0bb124&rfr_iscdi=true |