Abstract：Objective To investigate the efficacy and safety of modified endoscopic submucosal dissection (ESD) and rubber band ligation assisted endoscopic dissection for treatment of small gastric lipomas.Methods A total of thirty-seven patients who were diagnosed with gastric lipomas(6 mm≤diameter≤13 mm) originating from the submucosa layer by EUS in our hospital were enrolled in this study.With intravenous anesthesia in all the patients, modified ESD was performed first to stripe the small tumors. After exposure to some extent, the tumors were ligated by rubber band and snared for endoscopic dissection. Bleeding, intraoperative and postoperative perforation, the integrity and size of the resected specimens were observed and recorded. The resected specimens were identified with hystopathological examination.Six and twelve months after the operation, all the patients were reviewed by gastroscopy and EUS in our hospital.Results All the thirty-seven tumors were resected completely and successfully. The mean operating time was (12.6±2.5) min, the intraoperative blood loss was less than 2 ml, and there was no case of intraoperative perforation. No delayed bleeding or perforation occurred one week after operation. The tumor size ranged from 5 mm×6 mm to 12 mm×13 mm. Thirty-seven gastric lipomas were identified in postoperative pathology. There were no residues or recurrence in any of these cases during the follow-up period of 12 months.Conclusions Modified ESD and rubber band ligation assisted endoscopic dissection for treatment of small gastric lipomas are effective and safe. Tumors can be resected completely. Complete data on pathological diagnosis can become available. This approach can make up for the deficiency of endoscopic treatment Methods.
Baskaran V, Patnaik P K,Seth A K,et al.Intestinal lipoma:a rare cause of lower gastrointestinal haemorrhage[J].Trop Gastroenterol, 2003, 24(4): 208-210.
[3]
Vinces F Y, Ciacci J, Sperling D C, et al. Gastroduodunal intussusception secondary to a gastric lipoma [J].Can J Gastrocenterol, 2005, 19(2): 107-108.
[4]
Treska V, Pesek M, Kreuzberg B, et al. Gastric lipomas presenting as upper gastrointestinal obstruction[J]. J Gastroenterol, 1998, 33(5): 716-719.
Sun S, Wang M, Sun S. Use of endoscopic ultrasoundguided injection in endoscopic resection of solid submucosal tumors[J]. Endoscopy, 2002, 34(1): 82-85.
2016, Vol. 27 
