Endoscopic resection of small gastrointestinal stromal tumors.

BACKGROUND

The common treatment principle of gastrointestinal stromal tumors (GISTs) is complete resection of the tumor. The rapid development of endoscopic skill makes it possible to resect GISTs en-bloc through the endoscopic approach.

AIMS

The aim of this study is to evaluate the feasibility of endoscopic resection for small-size (<30 mm) gastric GISTs.

METHODS

A total of 25 patients with gastric GISTs underwent endoscopic resection assisted with needle knife, loop, and snare. Clinical data, perioperative outcomes, tumor size and microscopic characteristics, immunohistochemical staining results, and follow-up outcomes were recorded.

RESULTS

Endoscopic resection was successfully accomplished in 25 patients at age of 56.72 +/- 11.42 years. The average operation time was 58.52 +/- 21.84 min. Perforation for 2-6 mm occurred in seven patients (28%) and was closed well with clips, with no conversions to open surgery. No mortalities occurred. All tumors were located in the stomach, and had an average size of (11.64 +/- 6.12) mm (5-30 mm). The average length of hospitalization was 4.28 +/- 0.84 days. Out of the total of 25 patients, 21 (84%) were at very low risk and only one (4%) was at intermediate risk. Positive rate of CD117 and CD34 was 92 and 84%, respectively. A follow-up for 11.44 +/- 5.79 months (2-23 months) showed no recurrence or metastasis.

CONCLUSIONS

Endoscopic resection is feasible, safe, and effective for small-size gastric GISTs (<30 mm). Short-term follow-up evaluation merits favorable clinical results.