Clinical Research
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Sep 28, 2007; 13(36): 4897-4902
Published online Sep 28, 2007. doi: 10.3748/wjg.v13.i36.4897
Endoscopic management of gastrointestinal smooth muscle tumor
Xiao-Dong Zhou, Nong-Hua Lv, Hong-Xia Chen, Chong-Wen Wang, Xuan Zhu, Ping Xu, You-Xiang Chen
Xiao-Dong Zhou, Nong-Hua Lv, Chong-Wen Wang, Xuan Zhu, Ping Xu, You-Xiang Chen, Department of Gastro-enterology, First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Hong-Xia Chen, Department of Gynecology and Obstetrics, First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Xiao-Dong Zhou, Department of Gastroenterology, First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China. zhouxd7612@hotmail.com
Telephone: +86-791-8692540 Fax: +86-791-8623153
Received: May 25, 2007
Revised: June 15, 2007
Accepted: June 18, 2007
Published online: September 28, 2007
Abstract

AIM: To systematically evaluate the efficacy and safety of endoscopic resection of gastrointestinal smooth muscle tumors (SMTs, including leiomyoma and leiomyosarcoma) and to review our preliminary experiences on endoscopic diagnosis of gastrointestinal SMTs.

METHODS: A total of 69 patients with gastrointestinal SMT underwent routine endoscopy in our department. Endoscopic ultrasonography (EUS) was also performed in 9 cases of gastrointestinal SMT. The sessile submucosal gastrointestinal SMTs with the base smaller than 2 cm in diameter were resected by “pushing” technique or “grasping and pushing” technique while the pedunculated SMTs were resected by polypectomy. For those SMTs originating from muscularis propria or with the base size ≥ 2 cm, ordinary biopsy technique was performed in tumors with ulcers while the “Digging” technique was performed in those without ulcers.

RESULTS: 54 cases of leiomyoma and 15 cases of leiomyosarcoma were identified. In them, 19 cases of submucosal leiomyoma were resected by “pushing” technique and 10 cases were removed by “grasping and pushing” technique. Three cases pedunculated submucosal leiomyoma were resected by polypectomy. No severe complications developed during or after the procedure. No recurrence was observed. The diagnostic accuracy of ordinary and the “Digging” biopsy technique was 90.0% and 94.1%, respectively.

CONCLUSION: Endoscopic resection is a safe and effective treatment for leiomyomas with the base size ≤ 2 cm. The “digging” biopsy technique would be a good option for histologic diagnosis of SMTs.

Keywords: Gastrointestinal; Smooth muscle tumor; Endoscopy; Endoscopic ultrasonography; Management