Endoscopic submucosal excavation and endoscopic full-thickness resection for gastric schwannoma: five-year experience fr
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and Other Interventional Techniques
Endoscopic submucosal excavation and endoscopic full‑thickness resection for gastric schwannoma: five‑year experience from a large tertiary center in China Ya‑qi Zhai1,2 · Ning‑li Chai1 · Hui‑kai Li1 · Zhong‑sheng Lu1 · Xiu‑xue Feng1 · Wen‑gang Zhang1 · Sheng‑zhen Liu1 · En‑qiang Linghu1 Received: 8 July 2019 / Accepted: 28 November 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Background and aims Endoscopic resection (ER) is an effective and safe method for gastric submucosal tumors, mostly composed of gastrointestinal stromal tumors and leiomyomas. The role of ER in gastric schwannoma (GS) has rarely been described. Our aim was to evaluate the efficacy and safety of ER for GS. Methods This is a retrospective study in consecutive patients who underwent ER for GS from March 2013 to October 2018 at our center. Clinicopathological, endoscopic, and follow-up data were collected and analyzed. Results A total of 16 consecutive patients (9 females, 56.3%) were included, with a mean age of 50.4 years (range 25–75 years). The mean tumor size was 22.9 ± 15.1 mm (range 10–55 mm). Thirteen tumors (81.3%) were located in the middle third of the stomach and 12 tumors (75%) grew with intraluminal pattern. Endoscopic submucosal excavation (ESE) was performed in 7 patients while endoscopic full-thickness resection (EFTR) was done in 9 patients. R0 resection was achieved in 14 patients (87.5%). The mean operative time was 91.6 ± 52.8 min (range 36–203 min) and the mean postoperative length of hospital stays was 8.3 ± 2.7 days (range 6–13 days). No adverse events were encountered except for fevers in 2 patients. No patients required surgical resection or intervention. During long-term follow-up of mean 21.8 months (range 6–62 months), no residue, recurrence, or metastasis was observed. Conclusions ER is effective and safe for patients with GS with favorable long-term outcomes. Keywords Endoscopic submucosal excavation · Endoscopic full-thickness resection · Gastric schwannoma Gastric schwannoma (GS) is a rare gastric submucosal tumor (SMT) originating from Schwann cells in the neural plexus of the stomach, which accounts for 6.3% of gastric mesenchymal tumors, 4% of benign gastric tumors and 0.2% of all gastric tumors [1–3]. The majority of patients with GS are asymptomatic but some patients may present with abdominal pain or discomfort, and gastrointestinal (GI) bleeding [3, 4]. With the widespread use of screening Ya-qi Zhai and Ning-li Chai contribute to the paper equally, and are co-first authors. * En‑qiang Linghu [email protected] 1
Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Fuxing Road 28, Beijing 100853, China
Harvard Medical School, Boston, MA 02115, USA
2
esophagogastroduodenoscopy (EGD), incidental findings of GS have increased. Although considered benign tumors with very rare malignant potential for transformation, GS still remain preoperatively indistinguishable from other SMTs, such as G
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