Clinical Overview of GIST and Its Latest Management by Endoscopic Resection in Upper GI: A Literature Review

Cicilia Marcella, Rui Hua Shi, Shakeel Sarwar, Cicilia Marcella, Rui Hua Shi, Shakeel Sarwar

Abstract

Aims: To review the clinical presentation, diagnosis, assessment of risk of malignancy, and recent advances in management (mainly focusing on the role of endoscopic resection) of gastrointestinal stromal tumors (GISTs) in upper GI.

Method: We searched Embase, Web of science, and PubMed databases from 1993 to 2018 by using the following keywords: "gastrointestinal stromal tumors," "GIST," "treatment," and "diagnosis." Additional papers were searched manually from references of the related articles.

Findings: The improvement of endoscopic techniques in treating upper gastrointestinal subepithelial tumors especially gastrointestinal tumors has reduced the need for invasive surgery in patients unfit for surgery. Many studies have concluded that modified endoscopic treatments are effective and safe. These treatments permit minimal tissue resection, better dissection control, and high rates of en bloc resection with an acceptable rate of complications.

Figures

Figure 1
Figure 1
An approximately 3.9∗2.8 cm gastrointestinal tumor on the lesser curvature of the stomach body seen on enhanced CT imaging (white arrow).
Figure 2
Figure 2
A large gastrointestinal tumor located in the lower part of the cardia seen under endoscopy forming a smooth contoured elevation.
Figure 3
Figure 3
Gastric GISTs: risk assessment of malignant potential.
Figure 4
Figure 4
Endoscopic submucosal dissection. (a) A 2∗2 cm subepithelial tumor located in the gastric fundus. (b) Marking the lesion boundaries. (c) Incision of the tumor was made after lifting the submucosa layer by injecting a mixed solution into the submucosa layer. (d–f) Tumor is resected. (g) Endoscopic clips were used to close the wound. (h) The resected specimen.

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Source: PubMed

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