A novel technique for endoscope progression in gastroscopy resection: forward-return way for dissection of stromal tumor in the muscularis propria of the gastric fundus

Frontiers in Oncology · 8 authors, 1 centre

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TL;DR

This case series describes the Forward-Return Way (FRW) technique, a novel endoscope progression method for resecting gastrointestinal stromal tumors at the gastric fundus, which was successfully performed in 7 of 10 patients without complications.

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The FRW technique advances the gastroscope along the posterior wall of the upper gastric body and greater curvature, reaching the subcardia region without paradoxical movement. Among 10 patients treated between May 2020 and March 2021, the FRW technique was successfully performed in 7 cases (70%). Operation duration ranged from 47 to 122 minutes, and mean hospital stay was 7.29 ± 0.49 days. Histopathology revealed very low-risk tumors in 8 cases and low-risk tumors in 2 cases. No complications, residual or recurrent tumors, metastasis, or deaths were reported during follow-up.

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case_report

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surgery

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ORIGINAL PAPER

PMC10233095

A novel technique for endoscope progression in gastroscopy resection: forward-return way for dissection of stromal tumor in the muscularis propria of the gastric fundus

Frontiers in Oncology

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ABSTRACT

Abstract Background The fundus of the stomach is a challenging region for endoscopic resection of gastrointestinal stromal tumors (GISTs), especially in the anterior wall of the fornix at the side of the greater curvature. This study aimed to introduce the Forward-Return Way (FRW) technique in gastric fundus operations and provide evidence of its advantages. The FRW technique allows the gastroscope to access the stomach fornix without entering the gastric antrum after passing through the gastric cardia. Using FRW, the gastroscope body makes a forward return along the wall of the posterior wall of the upper gastric body and the wall of the greater curvature. Methods The clinical data of patients with stromal tumors in muscularis propria at the gastric fundus (STMF) at the Fourth Hospital of China Medical University between May 2020- March 2021 were reviewed. The novel FRW technique was used in the procedures, and the beneficial effects, suitability, applicable lesion site, and success rates of FRW were analyzed. Results A total of 10 cases were reviewed, and the FRW technique was successfully performed in 7 cases (70%). The gastroscope’s tip reached the area just below the gastric cardia, allowing endoscopists to successfully access all angles and sites of the stomach’s fundus in all seven patients. The lesion was easily accessed, and the gastroscope was stable with good left-right and forward-backwards movements. Conclusion The FRW technique significantly facilitates the resection of the GISTs by aligning the endoscopy body movement direction with the observation direction. Gastrointestinal Stromal Tumor; forward-return of gastroscopy along the gastric body wall; muscularis propria; gastric fundus. Keywords: gastrointestinal stromal tumor, Forward-Return Way, muscularis propria, gastric fundus, common submucosal tumor

CITATION EXPORT

Hai-Mei Guo, Ying Sun, Shuang Cai et al.. A novel technique for endoscope progression in gastroscopy resection: forward-return way for dissection of stromal tumor in the muscularis propria of the gastric fundus. Frontiers in Oncology. (2023). https://doi.org/10.3389/fonc.2023.1077201

AUTHORS

8 · 1 CENTRES

Hai-Mei Guo, Ying Sun, Shuang Cai, Feng Miao, Yan Zheng, Yang Yu, Zhi-Feng Zhao, Lu Liu

1 Department of Gastroenterology, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China