Submucosal tunneling endoscopic resection for the treatment of submucosal gastric tumor: new technic - new problems
Abstract
Submucosal tunneling endoscopic resection (STER) is a comparatively new method of treatment of submucosal masses of the upper gastrointestinal tract. According to the world literature, complications of these operations are relatively rare and primarily associated with development of pneumothorax, pneumoperitoneum, and subcutaneous emphysema. These problems are directly related to the technique of manipulation and predictable. In our practice we had a complication that developed in a 60 years old female, during removal 30 mm size submucosal gastric tumor (schwannoma) by STER technic. During the formation of the tunnel, the covering mucosa was ruptured. It was closed by endoscopic clipping. During the extraction of the resected tumor the fullthickness rupture of the upper part of esophagus and hypopharynx had occurred. The attempts of endoscopic suturing of the defect were unsuccessful and the open surgery was applied. The patient was discharged from the hospital in good health at the 21th day after the operation. In the publications on this topic, submucosal tunneling endoscopic resection of submucosal lesions of the upper gastrointestinal tract is quite a safe procedure. However, in view of its relative novelty and no large international experience, it is not always possible to foresee all possible difficulties. Therefore, these operations must be performed in a hospital with ample opportunities to deal with unforeseen complications.
About the Authors
A. N. Sidorova
State Research Institute of Oncology named after N.N. Petrov
Russian Federation
Russian Federation
O. B. Tkachenko
State Research Institute of Oncology named after N.N. Petrov
Russian Federation
Russian Federation
A. M. Sherbakov
State Research Institute of Oncology named after N.N. Petrov
Russian Federation
Russian Federation
O. V. Beloglazova
State Research Institute of Oncology named after N.N. Petrov
Russian Federation
Russian Federation
M. V. Grinkevich
State Research Institute of Oncology named after N.N. Petrov
Russian Federation
Russian Federation
U. V. Petrik
State Research Institute of Oncology named after N.N. Petrov
Russian Federation
Russian Federation
References
1. Blackstein M.E, Blay J.Y, Corless С, Driman D.K, Riddell R, Soulieres D, Swallow C.J, Verma S, on behalf of the Canadian Advisory Committee on GIST. Gastrointestinal stromal tumours: Consensus statement on diagnosis and treatment. Can J Gastroenterol 2006;20(3): 157-163.
2. Blay J.Y, Blomqvist C, Bonvalot S, Boukovinas I, Casali P.G, De Alava E, Dei Tos A, Dirksen U, Duffaud F, Eriksson M, Fedenko A, Ferrari A, Ferrari S, Garcia del Muro X, Gelderblom H, Grimer R, Gronchi A, Sundby Flail K, Flassan B, Hogendoorn P, Hohenberger P, Issels R, Joensuu H, Jost L, Jurgens FI, Kager L, Le Cesne A, Leyvraz S, Martin J, Merimsky O, Nishida T, Picci P, Reichardt P, Rutkowski P, Schlemmer M, Sleijfer S, Stacchiotti S, Taminiau A, Wardelmann E. Gastrointestinal stromal tumors: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology 23 (Suppl. 7): vii49-vii55
3. Demetri G.D., Mehren M, Antonescu С.R, DeMatteo R.P, Ganjoo K.N, Maki R.G, Pisters P.W.T, Raut C.P, Riedel R.F, Schuetze S, Sundar H.M, Trent J.C, Wayne J.D. NCCN Task Force Report: Update on the Management of Patients with Gastrointestinal Stromal Tumors. J Natl Compr Cane Netw 2010;8:S-1 -S-41
4. Gong W, Xiong Y, Zhi F, Liu S, Wang A, Jiang B. Preliminary experience of endoscopic submucosal tunnel dissection for upper gastrointestinal submucosal tumors. Endoscopy 2012; 44:231-235
5. Ikehara FI, Li Z, Watari J. Histological diagnosis of gastric submucosaltumors:Apilotstudyof endoscopic ultrasonography-guided fine-needle aspiration biopsy vs mucosal cutting biopsy World J Gastrointest Endosc 2015 October 10; 7(14): 11421149
6. Inoue H, Ikeda H, Hosoya T, Onimaru M, Yoshida A, Eleftheriadis N, Maselli R, Kudo S. Submucosal endoscopic tumor resection for subepithelial tumors in the esophagus and cardia. Endoscopy 2012; 44: 225-230
7. Kang Y.K, Kim K.M, Sohn T, Choi D, Kang H.J, Ryu M.H, Kim W.H, Yang H.K. Clinical Practice Guideline for Accurate Diagnosis and Effective Treatment of Gastrointestinal Stromal Tumor in Korea. J Korean Med Sci 2010; 25: 1543-1552.
8. Khashab M.A, Saxena P, Valeshabad A.K, Chavez Y.H, Zhang F, Akshintala V, Aguila G, Inoue H, Pasricha P.J, Neuhaus H, et al. Novel technique for submucosal tunneling and endoscopic resection of submucosal tumors (with video) Gastrointest Endosc. 2013; 77:646-648.
9. Kim G.H, Park D.Y, Kim S, Kim D.H, Kim D.H, Choi C.W, Heo J, Song G.A. Is it possible to differentiate gastric GISTs from gastric leiomyomas by EUS? World J Gastroenterol. 2009 Jul 21; 15(27):3376-81.
10. Lee S.H, Kim S.J, Lee T.H, Chung I.K, Park S.H, Kim E.O, Lee H.J, Cho H.D. Human applications of submucosal endoscopy under conscious sedation for pure natural orifice transluminal endoscopic surgery. Surg Endosc 2013; 27: 3016-3020
11. Liu B.R, Song J.T, Kong L.J, Pei F.H, Wang X.H, Du Y.J. Tunneling endoscopic muscularis dissection for subepithelial tumors originating from the muscularis propria of the esophagus and gastric cardia. Surg Endosc. 2013; 27:4354-4359.
12. Nishida T, Hirota S, Yanagisawa A, Sugino Y, Minami M, Yamamura Y, Otani Y, Shimada Y, Takahashi F, Kubota T. Clinical practice guidelines for gastrointestinal stromal tumor (GIST) in Japan: English version Int J Clin Oncol 2008 13:416-430
13. Papanikolaou I.S, Rosch T. Endoscopic ultrasonography for gastric submucosal lesions World J Gastrointest Endosc 2011 May 16; 3(5): 86-94
14. Polkowski M. Endoscopic ultrasound and endoscopic ultrasound-guided fine-needle biopsy for the diagnosis of malignant submucosal tumors. Endoscopy. 2005;37:635-645
15. Wang X.Y, Xu M.D, Yao L.Q, Zhou P.H, Pleskow D, Li Q.L, Zhang Y.Q, Chen W.F, Zhong Y.S. Submucosal tunneling endoscopic resection for submucosal tumors of the esophagogastric junction originating from the muscularis propria layer: a feasibility study (with videos) Surg Endosc. 2014;28:1971-1977
16. Xu M.D, Cai M.Y, Zhou P.H, Qin X.Y, Zhong Y.S, Chen W.F, Hu J.W, Zhang Y.Q, Ma L.L, Qin W.Z, Yao L.Q. Submucosal tunneling endoscopic resection: a new technique for treating upper Gl submucosal tumors originating from the muscularis propria layer (with videos). Gastrointest Endosc 2012; 75: 195-199
17. Ye L.P, Zhang Y, Mao X.L, Zhu L.H, Zhou X, Chen J.Y. Submucosal tunneling endoscopic resection for small upper gastrointestinal subepithelial tumors originating from the muscularis propria layer. Surg Endosc 2014; 28: 524-530
18. Ye L.P, Zhang Y, Mao X.L, Zhu L.H, Zhou X.B, He S.Q, Chen J.Y, Jin X. Submucosal tunnelling endoscopic resection for the treatment of esophageal submucosal tumours originating from the muscularis propria layer: an analysis of 15 cases. Dig Liver Dis. 2013;45:119-123
19. Zhang Y, Ye L.P, Mao X.L Endoscopic treatments for small gastric subepithelial tumors originating from muscularis propria layer. World J Gastroenterol. 2015 Aug 28; 21(32): 9503-9511.
20. Zhou D.J, Dai Z.B, Wells M.M, Yu D.L, Zhang J, Zhang L. Submucosal tunneling and endoscopic resection of submucosal tumors at the esophagogastric junction. World J Gastroenterol. 2015 Jan 14; 21(2):578-83.
Review
For citations:
Sidorova A.N., Tkachenko O.B., Sherbakov A.M., Beloglazova O.V., Grinkevich M.V., Petrik U.V. Submucosal tunneling endoscopic resection for the treatment of submucosal gastric tumor: new technic - new problems. Filin’s Clinical endoscopy. 2017;(1):64-69. (In Russ.)
Views:
24
JATS XML
Email this article 