Assessment of four types of endoscopic ligation in treatment of submucosal tumors in upper gastrointestinal tract

Abstract

Objective To evaluate the clinical efficacy and safety of 4 types of endoscopic nylon ligation in the treatment of submucosal tumors in upper gastrointestinal tract. Methods Those with submu- cosal tumors located in esophagus, stomach or duodenum were enrolled in the study. All patients were trea- ted with endoscopic nylon ligation, which included direct ligation, ligation with a transparent cap, ligation with dual-channel endoscope, and ligation in combination with endoscopic submucosal dissection （ESD）. The patients were followed up endoscopically for evaluation of efficacy and safety of the procedures. Results A total of 128 patients were recruited into the present study from June 2006 to December 2008. The tumors were in esophagus in 28 patients, in stomach in 82 and in duodenum in 18. Direct ligation was applied in 3 patients, ligation with a transparent cap in 105, ligation with a dual-channel endoscope in 8, and ligation plus ESD in 12. Endoscopic follow-up was completed in 111 patients. Reduced lesion size was observed in 16 patients （ I4.4% ） , residue nylon in 16 （ 14. 4% ） and no lesion in 71 others （63.9%）. The overall ef- fective rate was 92.8%. No delayed perforation or bleeding occurred. Conclusion Endoscopic ligation with nylon thread in combination with other assistant approaches is effective and safe for the treatment of submuco- sal tumors in upper gastrointestinal tract. Key words: Gastrointestinal neoplasms; Nylon thread ligation; Endoscopic submucosal dissection