Objective: To investigate the clinical features and safety of endoscopic resection of gastric stromal tumor. Method: Based on the analysis of 139 patients who were diagnosed as gastric stromal tumor by pathology and immunohistochemistry in Zhongda Hospital of Southeast University from January 2016 to December 2020. The lesions were evaluated by white light endoscopy, ultrasound endoscopy and abdominal CT before surgery, and the tumor size, location, operation method, operation time, postoperative complications and pathology were recorded. Result: No distant metastasis was found in 139 patients. There were 91 patients(65.46%) with fundus stromal tumor and 35 patients(25.18%) with gastric body. The age was 37-87 years and the mean age was(60.97±10.12) years. The tumor diameter ranged from 0.5-6.0 cm, with an average diameter of(2.03±1.47) cm. 97 patients presented varying degrees of upper abdominal discomfort(69.78%).135 patients(97.12%) showed lesions originating from the muscularis propria under ultrasound gastroscopy. If the tumor diameter was less than 1.5 cm, most patients showed no positive results on CT examination. Among 136 cases of complete endoscopic resection, diameter of 52 cases ≥ 2 cm, and the maximum diameter was 6 cm. No uncontrolled bleeding or perforation occurred during and after operation, and the other 3 cases were treated by laparoscopy. Conclusion: Gastric stromal tumor is more common in the fundus of the stomach, presenting with different degrees of upper abdominal discomfort, some asymptomatic by physical examination. Most of the lesions originated from the muscularis propria. When the lesion was larger than 1.5 cm, abdominal CT could show nodular protrusion or space-occupying changes. Endoscopic mucosal dissection and extension resection is a safe and effective method for the treatment of gastric stromal tumors, which can be considered for gastric stromal tumor with diameter ≤ 6 cm and no distant metastasis. |
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