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Endoscopic Submucosal Dissection for Subepithelial Tumor Treatment in the Upper Digestive Tract: A Western, Multicenter Study

BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) has been proposed for removal of gastrointestinal subepithelial tumors (GI-SETs), but data are still scanty. This study aimed to report a case series from a western country. PATIENTS AND METHODS: Data of patients with upper GI-SETs suitable for...

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Autores principales: Manta, Raffaele, Zito, Francesco Paolo, Pugliese, Francesco, Caruso, Angelo, Mangiafico, Santi, D'Alessandro, Alessandra, Castellani, Danilo, Germani, Ugo, Mutignani, Massimiliano, Conigliaro, Rita Luisa, Bonetti, Luca Reggiani, Matsuda, Takahisa, De Francesco, Vincenzo, Zullo, Angelo, Galloro, Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10050838/
https://www.ncbi.nlm.nih.gov/pubmed/37008525
http://dx.doi.org/10.1159/000525993
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author Manta, Raffaele
Zito, Francesco Paolo
Pugliese, Francesco
Caruso, Angelo
Mangiafico, Santi
D'Alessandro, Alessandra
Castellani, Danilo
Germani, Ugo
Mutignani, Massimiliano
Conigliaro, Rita Luisa
Bonetti, Luca Reggiani
Matsuda, Takahisa
De Francesco, Vincenzo
Zullo, Angelo
Galloro, Giuseppe
author_facet Manta, Raffaele
Zito, Francesco Paolo
Pugliese, Francesco
Caruso, Angelo
Mangiafico, Santi
D'Alessandro, Alessandra
Castellani, Danilo
Germani, Ugo
Mutignani, Massimiliano
Conigliaro, Rita Luisa
Bonetti, Luca Reggiani
Matsuda, Takahisa
De Francesco, Vincenzo
Zullo, Angelo
Galloro, Giuseppe
author_sort Manta, Raffaele
collection PubMed
description BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) has been proposed for removal of gastrointestinal subepithelial tumors (GI-SETs), but data are still scanty. This study aimed to report a case series from a western country. PATIENTS AND METHODS: Data of patients with upper GI-SETs suitable for ESD removal observed in 4 centers were retrospectively reviewed. Before endoscopic procedure, the lesion was characterized by endosonographic evaluation, histology, and CT scan. The en bloc resection and the R0 resection rates were calculated, as well as incidence of complications, and the 1-year follow-up was reported. RESULTS: Data of 84 patients with esophageal (N = 13), gastric (N = 61), and duodenal (N = 10) GI-SETs were collected. The mean diameter of lesions was 26 mm (range: 12–110 mm). There were 17 gastrointestinal stromal tumors, 12 neuroendocrine tumors, 35 leiomyomas, 18 lipomas, and 2 hamartomas. En bloc and R0 resection were achieved in 83 (98.8%) and in 80 (95.2%) patients, respectively. Overall, a complication occurred in 11 (13.1%) patients, including bleeding (N = 7) and perforation (N = 4). Endoscopic approach was successful in all bleedings, but 1 patient who required radiological embolization, and in 2 perforations, while surgery was performed in the other patients. Overall, a surgical approach was eventually needed in 5 (5.9%), including 3 in whom R0 resection failed and 2 with perforation. CONCLUSIONS: Our study found that ESD may be an effective and safe alternative to surgical intervention for both benign and localized malignant GI-SETs.
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spelling pubmed-100508382023-03-30 Endoscopic Submucosal Dissection for Subepithelial Tumor Treatment in the Upper Digestive Tract: A Western, Multicenter Study Manta, Raffaele Zito, Francesco Paolo Pugliese, Francesco Caruso, Angelo Mangiafico, Santi D'Alessandro, Alessandra Castellani, Danilo Germani, Ugo Mutignani, Massimiliano Conigliaro, Rita Luisa Bonetti, Luca Reggiani Matsuda, Takahisa De Francesco, Vincenzo Zullo, Angelo Galloro, Giuseppe GE Port J Gastroenterol Research Article BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) has been proposed for removal of gastrointestinal subepithelial tumors (GI-SETs), but data are still scanty. This study aimed to report a case series from a western country. PATIENTS AND METHODS: Data of patients with upper GI-SETs suitable for ESD removal observed in 4 centers were retrospectively reviewed. Before endoscopic procedure, the lesion was characterized by endosonographic evaluation, histology, and CT scan. The en bloc resection and the R0 resection rates were calculated, as well as incidence of complications, and the 1-year follow-up was reported. RESULTS: Data of 84 patients with esophageal (N = 13), gastric (N = 61), and duodenal (N = 10) GI-SETs were collected. The mean diameter of lesions was 26 mm (range: 12–110 mm). There were 17 gastrointestinal stromal tumors, 12 neuroendocrine tumors, 35 leiomyomas, 18 lipomas, and 2 hamartomas. En bloc and R0 resection were achieved in 83 (98.8%) and in 80 (95.2%) patients, respectively. Overall, a complication occurred in 11 (13.1%) patients, including bleeding (N = 7) and perforation (N = 4). Endoscopic approach was successful in all bleedings, but 1 patient who required radiological embolization, and in 2 perforations, while surgery was performed in the other patients. Overall, a surgical approach was eventually needed in 5 (5.9%), including 3 in whom R0 resection failed and 2 with perforation. CONCLUSIONS: Our study found that ESD may be an effective and safe alternative to surgical intervention for both benign and localized malignant GI-SETs. S. Karger AG 2022-09-06 /pmc/articles/PMC10050838/ /pubmed/37008525 http://dx.doi.org/10.1159/000525993 Text en Copyright © 2022 by The Author(s). Published by S. Karger AG, Basel https://creativecommons.org/licenses/by-nc/4.0/This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission.
spellingShingle Research Article
Manta, Raffaele
Zito, Francesco Paolo
Pugliese, Francesco
Caruso, Angelo
Mangiafico, Santi
D'Alessandro, Alessandra
Castellani, Danilo
Germani, Ugo
Mutignani, Massimiliano
Conigliaro, Rita Luisa
Bonetti, Luca Reggiani
Matsuda, Takahisa
De Francesco, Vincenzo
Zullo, Angelo
Galloro, Giuseppe
Endoscopic Submucosal Dissection for Subepithelial Tumor Treatment in the Upper Digestive Tract: A Western, Multicenter Study
title Endoscopic Submucosal Dissection for Subepithelial Tumor Treatment in the Upper Digestive Tract: A Western, Multicenter Study
title_full Endoscopic Submucosal Dissection for Subepithelial Tumor Treatment in the Upper Digestive Tract: A Western, Multicenter Study
title_fullStr Endoscopic Submucosal Dissection for Subepithelial Tumor Treatment in the Upper Digestive Tract: A Western, Multicenter Study
title_full_unstemmed Endoscopic Submucosal Dissection for Subepithelial Tumor Treatment in the Upper Digestive Tract: A Western, Multicenter Study
title_short Endoscopic Submucosal Dissection for Subepithelial Tumor Treatment in the Upper Digestive Tract: A Western, Multicenter Study
title_sort endoscopic submucosal dissection for subepithelial tumor treatment in the upper digestive tract: a western, multicenter study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10050838/
https://www.ncbi.nlm.nih.gov/pubmed/37008525
http://dx.doi.org/10.1159/000525993
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