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World J Gastrointest Endosc. Dec 16, 2014; 6(12): 592-599
Published online Dec 16, 2014. doi: 10.4253/wjge.v6.i12.592
Endoscopic resection of subepithelial tumors
Arthur Schmidt, Markus Bauder, Bettina Riecken, Karel Caca
Arthur Schmidt, Markus Bauder, Bettina Riecken, Karel Caca, Department of Gastroenterology and Oncology, Klinikum Ludwigsburg, 71640 Ludwigsburg, Germany
Author contributions: Schmidt A drafted the manuscript; Bauder M collected and analysed the EFTR data; Riecken B and Caca K reviewed the manuscript.
Correspondence to: Karel Caca, MD, PhD, Department of Gastroenterology and Oncology, Klinikum Ludwigsburg, Posilipo-Str. 1-4, 71640 Ludwigsburg, Germany. karel.caca@kliniken-lb.de
Telephone: +49-7141-9967201 Fax: +49-7141-9967209
Received: August 15, 2014
Revised: October 3, 2014
Accepted: October 28, 2014
Published online: December 16, 2014
Processing time: 125 Days and 2.7 Hours
Abstract

Management of subepithelial tumors (SETs) remains challenging. Endoscopic ultrasound (EUS) has improved differential diagnosis of these tumors but a definitive diagnosis on EUS findings alone can be achieved in the minority of cases. Complete endoscopic resection may provide a reasonable approach for tissue acquisition and may also be therapeutic in case of malignant lesions. Small SET restricted to the submucosa can be removed with established basic resection techniques. However, resection of SET arising from deeper layers of the gastrointestinal wall requires advanced endoscopic methods and harbours the risk of perforation. Innovative techniques such as submucosal tunneling and full thickness resection have expanded the frontiers of endoscopic therapy in the past years. This review will give an overview about endoscopic resection techniques of SET with a focus on novel methods.

Keywords: Subepithelial tumors; Submucosal tumors; Gastrointestinal stromal tumors; Endoscopic resection; Endoscopic full thickness resection

Core tip: This review gives an overview about current endoscopic management of subepithelial tumors. Endoscopic resection techniques, available clinical data and potential indications will be discussed in detail. The review focuses on novel advanced techniques like submucosal tunnelling and endoscopic full thickness resection.