Endoscopic submucosal dissection of gastrointestinal stromal tumors

Objective To investigate the efficacy and safety of endoscopic submucosal dissection （ESD） for removal of gastrointestinal stromal tumors （GISTs）. Methods Data of 22 patients with GISTs, who underwent ESD, were reviewed in terms of personal situation, location and size of lesions, clinical mani- festation, managements, pathology, complications and follow-up findings. Results The procedure was suc- cessfully performed in all patients and all lesions were removed by one procedure. The lesion size ranged from 0. 8 to 4. 0 cm and the operation time was 35-150 rain （ mean 64. 5 rain）. Mild bleeding occurred in all cases, which was successfully managed by argon plasma coagulation, hot biopsy probe or endoclip. Perfora- tion occurred in 4 patients （18. 1% ） , which were closed with endoclip. Abdominal distension was relieved with decompression, acid suppression with proton pump inhibitors and antibiotics in 3 cases, additional trans-abdominal puncture was needed in the other case. No severe hemorrhage occurred. The average length of hospitalization was 4. 5 days （3-10 d）. The patients were followed up for 3 to 18 months, and no tumor residue or recurrence was observed. Conclusion ESD is an effective and safe endoscopic procedure to remove GISTs. The main complications are bleeding and perforation, which, however, can be cured. Key words: Gastrointestinal stromal tumor;  Endoscopic submucosal dissection;  Treatment of perforation