Ligation-assisted endoscopic dissection： a novel technique for resection of small gastric tumors originating from muscularis propria

Abstract

Objective To evaluate the efficacy and safety of ligation-assisted endoscopic dissection （ED-L） technique for the removal of gastric tumors originating from muscularis propria. Methods A total of 33 patients with gastric tumors originating from muscularis propria less than 10 mm were treated with ED-L procedures. The tumor was ligated by elastic hands. Endoscopic dissection was performed until the tumor was partially or completely dissected from muscularis propria by using Hook knife and/or IT-knife. The wound was closed with metallic clips and medical adhesive. The patients were followed up 1 week, 1 month, 3 months, 6 months and 12 mouths thereafter with endoscopy, respectively. Results Of the 33 gastric tumors, there were 25 partial dissections and 8 complete dissections. All of the tumors sloughed completely. Pathological diagnoses of all the patients were acquired. No complications like perforation occurred except for one self-limiting and non-life-threatening hemorrhage. There was no recurrent case during the 3-18 months of follow-up period. Conclusion ED-L is a safe, effective and relatively simple technique for excision of small gastrointestinal tumors originating from muscularis propria, providing a histopathological diagnosis as well. Key words: Stomach ; Endoscopic ultrasonography ; Tumors originating from muscularis propria; Ligation-assisted endoscopic dissection