Modified endoscopic submucosal dissection with ligation for small tumors originated from gastric muscularis propria

Abstract

Objective To explore the therapeutic value of modified endoscopic submucosal dissec- tion with ligation （ESD-L） for small tumors originated from gastric museularis propria. Methods Total of 60 patients with tumors originated from gastric museularis propria, which was confirmed by endoscopic ultra- sonography and smaller than 12 mm and were recruited to the present study. The conventional ESD technique was used to dissect the tumor to the depth of muscularis propria. Then the bottom of the tumor and the be- neath museularis propria were ligated fully with a nylon loop. Further dissection was applied till the whole tumor was isolated. Results All 60 lesions were dissected completely with perforation occurred in 10 cases, which were managed successfully with metal hemoclip. Pathologic diagnosis was obtained in all lesions, and no recurrence was found during the follow-up. Conclusion Modified technique of ESD-L is effective for complete resection of small tumors originated from gastric museularis propria, which can also decrease the risk of stomach perforation. Key words: Ligation; Endoscopic submucosal dissection; Submucosal tumor; Inherent muscular layer; Therapy