GIST Endoscopic Therapy
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Digestive endoscopy is as efficient as surgery for the treatment of small gastric stromal tumors (sGSTs), according to a new review published in the World Journal of Gastrointestinal Oncology. The authors reported digestive endoscopy also has no effect on gastric function, causes less trauma, is cheaper, and leads to shorter hospital stays.

“For sGST patients with high-risk manifestations or those who cannot tolerate endoscopic follow-up but who actively demand treatment, endoscopic sGST resection by physicians experienced in endoscopic treatment is effective and safe,” the authors wrote.

Gastrointestinal stromal tumors (GISTs) can occur anywhere in the gastrointestinal tract and can become malignant. Gastric stromal tumors are the most common type of GIST, and there is no consensus on whether or not small GSTs (less than 2 cm in diameter) should be treated.

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This review addressed three questions surrounding the endoscopic treatment of sGSTs:

  • Should sGSTs be treated?
  • Is digestive endoscopy safe and effective in treating sGSTs?
  • Which endoscopic approach is most suitable?

Should sGSTs Be Treated?

According to the authors, sGSTs should be treated with digestive endoscopy because they have a high risk of becoming malignant and must be frequently evaluated with invasive techniques, which can lead to heavy economic and psychological burdens on patients.

“By communicating with sGST patients, researchers have found that most of such patients are strongly willing to undergo surgical or endoscopic treatment,” the authors wrote.

Is Digestive Endoscopy Safe and Effective in Treating sGSTs?

According to the authors of the review, digestive endoscopy has the same efficacy as traditional and laparoscopic surgery but causes less trauma, is associated with shorter operation times and lower treatment costs, and leads to fewer complications and a faster recovery.

Which Endoscopic Approach Is Most Suitable?

Endoscopic submucosal excavation seems to be suitable to treat sGSTs derived from the muscularis propria and growing into the gastric cavity. Endoscopic full-thickness resection, on the other hand, can treat sGSTs with intracavitary and extracavitary growth.

In cases where the tumor is close to the cardia of the stomach, submucosal-tunneling endoscopic resection seems to be the most suitable approach and offers advantages such as maintaining mucosal integrity, leading to small wounds, fast healing, and reduced risk of infections.


Chen ZM, Peng MS, Wang LS, Xu ZL. Efficacy and safety of endoscopic resection in treatment of small gastric stromal tumors: a state-of-the-art reviewWorld J Gastrointest Oncol. 2021;13(6):462-471. doi: 10.4251/wjgo.v13.i6.462