Efficiency and safety of endoscopic treatment of gastrointestinal smooth muscle tumors

Gastrointestinal smooth muscle tumors (SMTs, including leiomyoma and leiomyosarcoma) represent relatively common lesions that are thought to originate from a muscular layer of the gastrointestinal tract.

They can be found in the esophagus, stomach, small intestine, and colon. SMTs are difficult to cure gastrointestinal tumors when compared with polyps, and complete surgical resection is still considered to be the most definitive therapy. The efficiency and safety of the endoscopic treatment of SMTs is largely unknown because of a lack of convincing evidence.

A research article published in the September 28 issue of the World Journal of Gastroenterology addresses these issues of efficiency and safety. A research team led by Dr. Xiao-Dong Zhou from the First Affiliated Hospital of Nanchang University spent more than 15 years working with a cohort of 69 patients with gastrointestinal smooth muscle tumors (SMTs) who had accepted endoscopic examination and treatment. The large sample size allowed them to obtain results with high statistical significance and draw very reliable conclusions.

The main finding they reported is that endoscopic resection is a safe and effective treatment for SMTs with a base size ¡Ü 2 cm when the "pushing" or "grasping and pushing" technique is used and the pedunculated SMTs are resected by polypectomy. No severe complications developed during or after the procedure in any of the cases. Further, no recurrence was observed.

Another interesting finding is that the diagnostic accuracy of ordinary and "digging" biopsy techniques was 90.0% and 94.1%, respectively. Thus, the "digging" biopsy technique is a good option for the histologic diagnosis of SMTs. The investigators suggested that endoscopic resection is a safe and effective treatment for leiomyomas with a base size ¡Ü 2 cm and that patients should not worry about recurrence after endoscopic resection.