Researchers reported encouraging results of endoscopic subserosal dissection (ESSD) in selected patients with gastrointestinal stromal tumors (GISTs) and published their results n Surgical Endoscopy. They found the approach safe and effective for epithelial tumors with severe fibrosis and mixed or exophytic gastric subepithelial tumors in the muscularis propria that could not be treated with usual methods.

“Our findings from 18 patients who underwent ESSD for gastric tumors could show potential of endoscopic resection,” the authors wrote.

“We had a 94% complete resection rate, and only three patients experienced perforation, which is a common concern with ESSD. Further, with a mean follow-up of 70 months, no patients have experienced recurrence.”


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The research team conducted a retrospective evaluation of 18 patients with GISTs who underwent ESSD between 2010 and 2019. ESSD is gaining attention due to the ease with which the surgeon can access the lesser curvature or fundus area of the stomach, and it offers a better view than other surgical approaches.

Furthermore, it offers a better cost-benefit profile, shorter hospitalization period, and improved postoperative quality of life compared to standard surgery. The results of this study showed that ESSD is relatively safe for tumors in the lesser curvature, fundus, or cardia.

The authors note that there is a higher risk of perforation for tumors located in the posterior wall or greater curvature when using this technique. However, management techniques such as traction methods are rapidly evolving and should help lessen the rate of this complication. They recommend further study of the ESSD technique as compared to laparoscopic treatment to better determine the clinical feasibility of this approach.

Reference

Han J, Cho J, Song J, Yang M, Lee Y, Ju M. Endoscopic subserosal dissection for gastric tumors: 18 cases in a single center. Surg Endosc. Published online April 19, 2022. doi:10.1007/s00464-022-09229-3