Endoscopic resection for gastric schwannoma with long-term outcomes.

Abstract

Gastric schwannoma is not so recognized by clinicians as its counterparts. The efficacy of endoscopic resection has not been described yet. Our aim was to assess the efficacy and safety of endoscopic resection in the management of gastric schwannoma. Retrospective data were reviewed from January 2008 to December 2013 in our center. Fourteen patients who had endoscopic resection with the final pathology result of gastric schwannoma were included in the study. Of the 14 patients, there were 12 females and two males. The median age was 59years (range 32-83). Thirteen tumors (92.9%) were from the muscularis propria and one located in the submucosa. Endoscopic en bloc resection was achieved in 12 patients (12/14, 85.7%), including seven cases of endoscopic full-thickness resection (EFTR). The mean resected tumor size was 1.73±1.10cm (range 0.3-4.0cm). In one case, endoscopic resection was suspended due to the limited experience of EFTR during the early period of the study. In another case, due to the difficult tumor location (gastric angle) and extraluminal growth pattern, the patient was referred to laparoscopic surgery. In the 12 successful endoscopic resection cases, during the median follow-up time of 4years (range 17-77months, one patient lost), no tumor residue, recurrence or metastasis was found. Endoscopic resection is safe and effective in treating gastric schwannoma with excellent long-term outcomes. However, it should be performed with caution because schwannoma is mainly located in the deep muscular layer, which leads to the full-thickness resection of gastric wall.