A new study reports that endoscopic resection may be safe and effective for gastrointestinal stromal tumors (GISTs). The study, published in the Scandinavian Journal of Gastroenterology, notes that even piecemeal resection can be performed without affecting recurrence or survival.
“GISTs are mostly located in the muscularis propria and grow in various ways; endoscopic resection may have disadvantages such as incomplete resection, uncontrollable bleeding, perforation, and infection,” the authors wrote. “Therefore, the aim of this retrospective study was to evaluate the efficacy and safety of [endoscopic resection] for gastric GISTs and discuss the endoscopic treatment for small gastric GISTs at a single medical center in China.”
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The study included 240 patients with GIST who had undergone endoscopic resection between 2010 and 2019. The main surgical techniques used to resect the tumors were endoscopic submucosal dissection and endoscopic full-thickness resection, although different approaches were used in a few cases. Of the 240 tumors, 233 were resected en bloc. Due to their large size, 7 tumors required piecemeal resection.
Bleeding occurred in 43 cases and included acute intraoperative bleeding and delayed postoperative bleeding, but only 1 patient required emergency surgery. Perioperative perforation occurred in 101 patients, and it was successfully treated with metal clips or string sutures. Patients with perforation had increased antibiotic use and abdominal pain, and the complication prolonged hospital stay and time to liquid diet. However, the length of hospital stay and time to liquid diet were still within acceptable limits for these patients.
Forty-seven patients were lost to follow-up, and the rest were followed for 30 months. Among them, the wounds healed well and no residual tumors, metastasis, or recurrence were observed. The authors concluded that endoscopic resection could generally be performed safely and effectively in patients with GIST.
Wang D, Ding Q, Cao L, et al. Clinical outcomes of endoscopic treatment for gastric gastrointestinal stromal tumors: a single-center study of 240 cases in China. Scand J Gastroenterol. Published online March 7, 2022. doi:10.1080/00365521.2022.2045351