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Gastrointestinal Subepithelial Lesions: Evolution in Management and Endoscopic Resection Techniques
Ahmad Abulawi1, Stephen Hasak2, Ricardo Marrero Torres3
1Division of Gastroenterology & Hepatology, Albany Medical College, 47 New Scotland Ave, Albany, NY, 12208, USA. abulawa@amc.edu.
Current Gastroenterology Reports
|February 8, 2025
Summary
Endoscopic Ultrasound (EUS) aids in characterizing gastrointestinal subepithelial lesions (SELs). Advanced endoscopic resection techniques offer minimally invasive, organ-sparing options for complete SEL removal.
Area of Science:
- Gastroenterology
- Endoscopic Surgery
Background:
- Subepithelial lesions (SELs) are common gastrointestinal findings.
- These lesions originate from the GI tract wall and are covered by mucosa.
- SELs are often discovered incidentally during endoscopy.
Purpose of the Study:
- To review recent advancements in endoscopic techniques and devices for SEL resection.
- To highlight the shift towards minimally invasive endoscopic approaches.
Main Methods:
- Endoscopic Ultrasound (EUS) for lesion characterization and "endoscopic mapping".
- Fine needle core biopsy (FNB) for histopathologic diagnosis.
- Review of various endoscopic resection techniques: Submucosal Tunnelling Endoscopic Resection (STER), Device-Assisted Endoscopic Full Thickness Resection, and Freehand Full Thickness Resection.
Main Results:
- EUS with FNB is crucial for SEL characterization and tissue acquisition.
- Multiple endoscopic resection techniques are available, chosen based on lesion characteristics and endoscopist expertise.
- A trend towards organ-sparing endoscopic resection over traditional surgery is evident.
Conclusions:
- Minimally invasive endoscopic resection is increasingly preferred for SELs.
- Advancements in "third space" endoscopy and novel devices enhance resection techniques.
- Endoscopic approaches offer effective and less invasive treatment for GI tract wall lesions.
Keywords:
Device assisted endoscopic full thickness resectionEndoscopic resection techniquesFreehand full thickness resectionGastrointestinal subepithelial lesionsSubmucosal tunneling endoscopic resection (STER)“Third space” endoscopyMore Related Videos
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