Endoscopic removal of gastrointestinal stromal tumors of the stomach. Own experience and literature review


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Abstract

Background. Over the past few years, the approach to the treatment of gastrointestinal stromal tumors (GIST) has undergone significant changes, reflecting a clearer understanding of the nature of the tumor and the possibility of determining the degree of its malignancy at the preoperative stage. To date, sufficient international experience in the removal of small-sized GISTs using various endoscopic technologies has been gained. Objective: a review of modern endoscopic techniques for the removal of gastric GIST and the presentation of authors' own experience. Methods. From March 2014 to September 2018, a single-site prospective study in the Loginov MCRC was conducted; study included 22 patients with GIST. All tumors were removed by an endoscopic method using the submucosal tunneling endoscopic resection (STER) technique. Results. In total, 25 gastric tumors were removed by a tunneled technique. The average size of the tumors was 17 mm, the smallest size of the neoplasms - 13 mm, the largest - 37 mm. The average duration of the operation was 145.9 minutes. All tumors were removed without damaging the integrity of the capsule. According to the results of an immunohistochemical examination, 12 removed tumors were a low-grade malignant GIST. Four removed tumors were assigned to an intermediate group, with the need for imatinib adjuvant chemotherapy in two cases. Seven neoplasms were leiomyomas. Conclusion. Authors’ own experience and literature data suggest that tunneled dissection can be an alternative to surgical resection in the treatment of patients with a GIST of a specific location. Nevertheless, further evaluation of the problem and accumulation of experience with obtaining long-term results are necessary to confirm the data obtained.

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About the authors

K. V Shishin

A.S. Loginov Moscow Clinical Research Center of the Moscow Healthcare Department

PhD in Medical Sciences, Researcher at the Department of Surgical Endoscopy

I. Yu Nedoluzhko

A.S. Loginov Moscow Clinical Research Center of the Moscow Healthcare Department

N. A Kurushkina

A.S. Loginov Moscow Clinical Research Center of the Moscow Healthcare Department

I. I Khvorova

A.S. Loginov Moscow Clinical Research Center of the Moscow Healthcare Department

Lada V. Shumkina

A.S. Loginov Moscow Clinical Research Center of the Moscow Healthcare Department

Email: l.shumkina@mknc.ru

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