Endoscopic submucosal dissection in the treatment of giant gastrointestinal lipomas

Abstract

Objective To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) in the treatment of giant gastrointestinal lipomas.Methods From August 2007 to August 2010,the clinical data of 32 patients with giant gastrointestinal lipomas treated by ESD at Endoscopy Center,Zhongshan Hospital Fudan University were retrospectively analyzed.Among 32 cases of giant gastrointestinal lipomas,one case was in esophagus,six cases in stomach,two cases in duodenum,seven cases in ileocecal valve,15 cases in colon and one case in rectum. Preoperative diagnostic accuracy of endoscopic uhrasonography (EUS) was 93.8％ (30/32).The maximum diameter of tumor ranged from 3.0 cm to 8.0 cm (average 4.2 cm).Results All tumors were successfully dissected under endoscopy.The success rate was 100％ (32/32).The operation time was between 25 minutes and 110 minutes (average 37 minutes).The average intraoperative blood loss was 40 ml,and no perforation and delayed bleeding was found after ESD. All were proved to be lipomas by histopaphology after operation.The rate of follow-up was 90.6％ (29/32).The follow-up time was from six to 36 months.Conclusion ESD is a safe and effective method for the treatment of giant gastrointestinal lipomas,which can be applied extensively in clinical. Key words: Endoscopy, digestive system; Gastric mucosa; Intestinal mucosa; Gastrointestinal neoplasms ; Lipoma