[Therapeutic value of endoscopic submucosal dissection for gastrointestinal stromal tumor in the esophagogastric junction].

OBJECTIVE

To evaluate the safety and efficacy of endoscopic submucosal dissection (ESD) for gastrointestinal stromal tumor(GIST) in the esophagogastric junction(EGJ).

METHODS

Twenty patients with pathologically confirmed GIST in the EGJ were screened from all the patients undergoing ESD between November 2007 and June 2011. The clinicopathological and postoperative follow up data were analyzed.

RESULTS

There were 11 males and 9 females with the age ranging from 29 to 67 years(mean, 54.1 years). The maximum diameter of the lesions ranged from 8 to 20 mm(mean,14.8 mm). Fifteen patients underwent endoscopic submucosal excavation, 4 patients underwent endoscopic full-thickness resection, and 1 patient underwent submucosal tunneling endoscopic resection. The operative time ranged from 15 to 90 min(mean, 47.8 minutes). The estimated blood loss was 5 to 200 ml. The en bloc resection rate was 100%. Perforations occurred in 4 patients, pneumoperitoneum in 3 patients, cardia mucosal tear in 1 patient. All the complications were successfully managed with endoscopic intervention and conservative therapy. The post-operative follow up ranged from 3 to 36 months(mean, 13.2 months). No local recurrence or distant metastasis occurred.

CONCLUSION

ESD is a safe and effective procedure for GIST in the EGJ.