Published online Feb 16, 2025. doi: 10.4253/wjge.v17.i2.101676
Revised: January 21, 2025
Accepted: February 6, 2025
Published online: February 16, 2025
Processing time: 142 Days and 19.8 Hours
The term subepithelial lesions encompasses a wide array of pathology of which numerous benign and malignant pathologies are grouped. A subset of these lesions are termed gastric mesenchymal tumours of which some have innate malignant potential. Currently there is various guidance on the recommended approach to the investigation and management of these lesions and there exists multiple methods of resection. Lin et al have developed and proposed a new method of resection of these gastric mesenchymal tumours within the field of endoscopy, a procedure they have termed endoscopic calabash ligation and resection. This editorial aims to outlay the current landscape for gastric mesenchymal tumours with regards to the various guidelines and resection techniques while comparing Lin et al’s new technique to those that are already established in the field of endoscopy. Advancements in endoscopy that maintain or improve patient outcomes compared to the gold standard approach are exciting developments. Lin et al’s study suggests that their technique is comparable in regard to patient outcomes while simultaneously being more efficient in its use of hospital resources including procedural time. Whilst the data and analysis proposed in the study is promising, there are areas that need to be addressed before advocating the procedure for widespread use. However, with further studies and analysis this may be foreseeable in the future.
Core Tip: The current management of gastric stromal tumours under 20 mm can be via active surveillance or resection. Endoscopic calabash ligation and resection technique offers an exciting new way of resecting endoscopically compared to standard excision techniques already in use. Whilst showing some promising benefits in data outcomes, further studies are warranted to address the limitations in the current study.