Endoscopic treatment for gastrointestinal stromal tumor: Advantages and hurdles

查看全文 作　　者：Hyung Hun [1]Kim

机构地区：[1]Department of Internal Medicine, the Catholic University of Korea College of Medicine

出　　处：《World Journal of Gastrointestinal Endoscopy》索引2015年第7卷第3期,共14页

基　　金：Supported by The Science Research Program through the National Research Foundation of Korea(NRF);the Ministry of Science,ICT and Future Planning,No.NRF-2013R1A1A1009682 摘　　要：One of the most prominent characteristics of gastrointestinal stromal tumors(GISTs) is their unpredictable and variable behavior. GISTs are not classified as 'benign' or 'malignant' but are rather stratified by their associated clinical risk of malignancy as determined by tumor size, location, and number of mitoses identified during surgicalhistology. The difficulty in assessing the malignant potential and prognoses of GISTs as well as the increasing incidence of 'incidental GISTs' presents challenges to gastroenterologists. Recently, endoscopic enucleation has been actively performed as both a diagnostic and therapeutic intervention for GISTs. Endoscopic enucleation has several advantages, including keeping the stomach intact after the removal of GISTs, a relatively short hospital stay, a conscious sedation procedure, relatively low cost, and fewer human resources required compared with surgery. However, a low complete resection rate and the risk of perforation could reduce the overall advantages of this procedure. Endoscopic full-thickness resection appears to achieve a very high R0 resection rate. However, this technique absolutely requires a very skilled operator. Moreover, there is a risk of peritoneal seeding due to large active perforation. Laparoscopy endoscopy collaborations have been applied for more stable and pathologically acceptable management. These collaborative procedures have produced excellent outcomes. Many procedures have been developed and attempted because they were technically possible. However, we should first consider the theoretical basis for each technique. Until the efficacy and safety of sole endoscopic access are proved, the laparoscopy endoscopy collaborative procedure appears to be an appropriate method for minimally destructive GIST surgery. 关键词：GASTROINTESTINAL STROMAL TUMOR ENDOSCOPY LAPAROSCOPY EFFICACY Safety

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Endoscopic treatment for gastrointestinal stromal tumor: Advantages and hurdles

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