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.
Reference: Zhou XD, Lv NH, Chen HX, Wang CW, Zhu X, Xu P, Chen YX. Endoscopic management of gastrointestinal smooth muscle tumor. World J Gastroenterol 2007; 13(36): 4897-4902 http://www.wjgnet.com/1007-9327/13/4897.asp
Correspondence to: Xiao-Dong Zhou, Department of Gastroenterology, First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China. zhouxd7612@hotmail.com Telephone: +86-791-8692540 Fax: +86-791-8623153
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World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection for providing a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. The WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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