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Endoscopic Management of Upper Gastrointestinal Submucosal Tumors Arising from Muscularis Propria

Lu, Jiaoyang MD*; Lu, Xuefeng MD; Jiao, Taotao MD; Zheng, Minhua MD, PhD*

Journal of Clinical Gastroenterology: September 2014 - Volume 48 - Issue 8 - p 667–673
doi: 10.1097/MCG.0000000000000135
Clinical Reviews

Small (<2 cm) or incidentally found gastrointestinal submucosal tumors pose challenges to gastroenterologists due to the potential malignancy of tumors and current suboptimal diagnostic methods. On the basis of the development of endoscopic submucosal dissection, recent technical advances, including endoscopic submucosal excavation, submucosal tunneling and endoscopic resection, and endoscopic full-thickness resection, have been able to resect submucosal tumors in the muscularis propria. These techniques provide definitive histologic diagnosis as well as a minimally invasive therapeutic approach to such tumors. Current studies, despite with promising results, are limited to small, retrospective studies, focusing on introducing new methods and varied in technical details. This review provides a thorough discussion of technical details of each endoscopic method, and compares different methods in terms of tumor sites, to ensure safety and optimize treatment outcomes.

*Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai

Department of Statistics, Shandong Provincial Hospital

Department of Gastroenterology, Qilu Hospital, Shandong University School of Medicine, Jinan, Shandong, China

Supported by the National High Technology Research and Development Program 863 of China (Project Grant 2012AA021103).

The authors declare that they have nothing to disclose.

Reprints: Xuefeng Lu, MD, and Minhua Zheng, MD, PhD, Department of Gastroenterology, Qilu Hospital, Shandong University School of Medicine, Jinan, Shandong 250012, China (e-mail: lu0801shanyi@163.com).

© 2014 by Lippincott Williams & Wilkins