The Role of Hemoclips Reinforcement in the Ligation-assisted Endoscopic Enucleation for Small GISTs in Gastric Fundus

Overview

Journal Biomed Res Int

Publisher Wiley

Specialties Biomedical Engineering
Biotechnology
General Medicine

Date 2014 Jun 5

PMID 24895557

Citations 5

Authors

Ge Nan

Sun Siyu

Wang Sheng

Liu Xiang

Guo Jintao

Affiliations

Soon will be listed here.

Abstract

Background: Endoscopic ultrasonography- (EUS-) assisted band ligation has been proven to be a safe and effective procedure for the treatment of small gastrointestinal stromal tumors (GISTs) apart from the relatively high risk of the postligation perforation of the gastric fundus. The aim of this study is to investigate the efficacy of hemoclip reinforcement in treating small GISTs in the gastric fundus.

Method: During a standard endoscopy, a transparent cap attached to the endoscopic tip was placed over the lesion to exert sustained maximal aspiration before a rubber band was released. Once a definite ligation was confirmed by EUS, the tumor was enucleated. Four to 6 hemoclips were placed on the folds around the ligation band to reduce the tension of the ligation site.

Results: The small GISTs were resected completely in 192 patients. Two cases of delayed perforation were found 72 hours after the procedure and successfully treated with an ordinary conservative method.

Conclusion: Hemoclip-reinforced endoscopic band ligation with systematic follow-up using EUS appears to be a simple and effective technique for the resection of small GISTs in the gastric fundus.

Citing Articles

Band-assisted endoscopic mucosal resection for small (≤ 1.5 cm) submucosal tumors originating from the muscularis propria in the gastric fundus: a prospective study.

Pan W, Shi D Surg Endosc. 2022; 37(3):1806-1812.

PMID: 36229551 DOI: 10.1007/s00464-022-09688-8.

Clinical Overview of GIST and Its Latest Management by Endoscopic Resection in Upper GI: A Literature Review.

Marcella C, Shi R, Sarwar S Gastroenterol Res Pract. 2018; 2018:6864256.

PMID: 30515204 PMC: 6234434. DOI: 10.1155/2018/6864256.

Endoscopic resection of gastric gastrointestinal stromal tumors.

Tan Y, Tan L, Lu J, Huo J, Liu D Transl Gastroenterol Hepatol. 2018; 2:115.

PMID: 29354772 PMC: 5763013. DOI: 10.21037/tgh.2017.12.03.

Clinical Control Study of Endoscopic Full-thickness Resection and Laparoscopic Surgery in the Treatment of Gastric Tumors Arising from the Muscularis Propria.

Wu C, Huang L, Guo J, Zhang B, Cui J, Sun C Chin Med J (Engl). 2015; 128(11):1455-9.

PMID: 26021500 PMC: 4733781. DOI: 10.4103/0366-6999.157651.

Endoscopic versus open resection for small gastric gastrointestinal stromal tumors: safety and outcomes.

Shen C, Chen H, Yin Y, Chen J, Han L, Zhang B Medicine (Baltimore). 2015; 94(1):e376.

PMID: 25569663 PMC: 4602836. DOI: 10.1097/MD.0000000000000376.

References

Sun S, Ge N, Wang C, Wang M, Lu Q . Endoscopic band ligation of small gastric stromal tumors and follow-up by endoscopic ultrasonography. Surg Endosc. 2006; 21(4):574-8. DOI: 10.1007/s00464-006-9028-4. View

Evans H . Smooth muscle tumors of the gastrointestinal tract. A study of 56 cases followed for a minimum of 10 years. Cancer. 1985; 56(9):2242-50. DOI: 10.1002/1097-0142(19851101)56:9<2242::aid-cncr2820560918>3.0.co;2-5. View

Sun S, Jin Y, Chang G, Wang C, Li X, Wang Z . Endoscopic band ligation without electrosurgery: a new technique for excision of small upper-GI leiomyoma. Gastrointest Endosc. 2004; 60(2):218-22. DOI: 10.1016/s0016-5107(04)01565-2. View

Jeon S, Park Y, Chung Y, Cho C, Tak W, Kweon Y . Gastrointestinal stromal tumors of the stomach: endosonographic differentiation in relation to histological risk. J Gastroenterol Hepatol. 2007; 22(12):2069-75. DOI: 10.1111/j.1440-1746.2006.04767.x. View

Kwon S . Surgery and prognostic factors for gastric stromal tumor. World J Surg. 2001; 25(3):290-5. DOI: 10.1007/s002680020040. View

Lee I, Lin P, Tung S, Shen C, Wei K, Wu C . Endoscopic submucosal dissection for the treatment of intraluminal gastric subepithelial tumors originating from the muscularis propria layer. Endoscopy. 2006; 38(10):1024-8. DOI: 10.1055/s-2006-944814. View

Dholakia C, Gould J . Minimally invasive resection of gastrointestinal stromal tumors. Surg Clin North Am. 2008; 88(5):1009-18, vi. DOI: 10.1016/j.suc.2008.05.006. View

Jensen D, Machicado G . Hemoclipping of chronic canine ulcers: a randomized, prospective study of initial deployment success, clip retention rates, and ulcer healing. Gastrointest Endosc. 2009; 70(5):969-75. PMC: 3789654. DOI: 10.1016/j.gie.2009.04.052. View

Sun S, Ge N, Wang S, Liu X, Lu Q . EUS-assisted band ligation of small duodenal stromal tumors and follow-up by EUS. Gastrointest Endosc. 2009; 69(3 Pt 1):492-6. DOI: 10.1016/j.gie.2008.05.025. View

10.

Jensen D, Machicado G, Hirabayashi K . Randomized controlled study of 3 different types of hemoclips for hemostasis of bleeding canine acute gastric ulcers. Gastrointest Endosc. 2006; 64(5):768-73. DOI: 10.1016/j.gie.2006.06.031. View

11.

Guo J, Liu Z, Sun S, Wang S, Ge N, Liu X . Endosonography-assisted diagnosis and therapy of gastrointestinal submucosal tumors. Endosc Ultrasound. 2014; 2(3):125-33. PMC: 4062264. DOI: 10.7178/eus.06.003. View

12.

Connolly E, Gaffney E, Reynolds J . Gastrointestinal stromal tumours. Br J Surg. 2003; 90(10):1178-86. DOI: 10.1002/bjs.4352. View

13.

Darnell A, Dalmau E, Pericay C, Musulen E, Martin J, Puig J . Gastrointestinal stromal tumors. Abdom Imaging. 2006; 31(4):387-99. DOI: 10.1007/s00261-004-0092-8. View

14.

Goh B, Chow P, Kesavan S, Yap W, Wong W . Outcome after surgical treatment of suspected gastrointestinal stromal tumors involving the duodenum: is limited resection appropriate?. J Surg Oncol. 2008; 97(5):388-91. DOI: 10.1002/jso.20954. View

15.

Siyu S, Sheng W, Guoxin W, Nan G, Jingang L . Gastric perforations after ligation of GI stromal tumors in the gastric fundus. Gastrointest Endosc. 2010; 72(3):615-6. DOI: 10.1016/j.gie.2010.02.032. View

16.

Fujimoto Y, Nakanishi Y, Yoshimura K, Shimoda T . Clinicopathologic study of primary malignant gastrointestinal stromal tumor of the stomach, with special reference to prognostic factors: analysis of results in 140 surgically resected patients. Gastric Cancer. 2003; 6(1):39-48. DOI: 10.1007/s101200300005. View