Efficacy of Endoscopic Submucosal Excavation for Gastrointestinal Stromal Tumors in the Cardia.

OBJECTIVE

Our goal was to estimate the feasibility and efficacy of endoscopic submucosal excavation (ESE) for the treatment of gastrointestinal stromal tumors (GISTs) in the cardia.

MATERIALS AND

METHODS

We analyzed the clinical data of 30 patients who were diagnosed with GISTs after ESE in the cardia at the Endoscopy Center of Renmin Hospital of Wuhan University (China) from June 2009 to 2015. We evaluated the operative and postoperative conditions and long-term follow-up of these patients.

RESULTS

The success rate and the complete resection rate were both 100%. The maximum diameter of the tumor ranged from 1.0 to 3.5 cm (2.2±0.2 cm). The operation time was 20 to 120 min (50±5 min). During ESE, bleeding occurred in all cases (100%) with a mean blood loss of 50 mL, and perforation in 6 (20%), including 2 full-thickness resections. GIST was confirmed by pathology in all cases. Follow-up included endoscopy at 1, 3, and 6 months, and at 1 year. At 1 month, ulcer was detected in 23 cases (76.67%), titanium clips remained in 17 cases (56.67%), and scar tissues were observed in the remainder. No recurrence was found with gastroscopy.

CONCLUSIONS

The cardia is a unique anatomic location for GISTs, which often requires complex surgeries prone to complications. ESE for GISTs of the cardia is a challenging, but safe and effective procedure.