Clinical Endoscopy

Original Articles

Feasibility and diagnostic performance of heparinized wetsuction and single-pass single-needle actuation endoscopic ultrasound-guided tissue acquisition for subepithelial lesions in Japan: a single-center retrospective study: Kotaro Takeshita, Satoshi Asai, Kenji Matsuo, Takumi Sugihara, Kensei Kawasaki, Aoi Koizumi, Sayuri Hashimoto, Kaho Takagi, Yoshihiro Shima, Tomoya Hashimura, Kento Hisamatsu, Yuma Fujita, Yuichiro Hamamoto, Shuta Otachi, Yuki Kano, Eisuke Nakao, Eisuke Akamine, Yoshinobu Hirose; Received September 24, 2025 Accepted February 1, 2026 Published online August 13, 2026; DOI: https://doi.org/10.5946/ce.2025.354 [Epub ahead of print]

Graphical Abstract Abstract PDF Supplementary Material: Background
/Aims: Heparinized wet suction (HEP) and the single-pass single-needle actuation method (HEP1p1a) are promising for endoscopic ultrasound-guided tissue acquisition (EUS-TA) because they improve specimen quality. However, its applicability in the biopsy of subepithelial lesions (SELs) remains unexamined. Therefore, this study evaluated the clinical utility of EUS-TA using HEP1p1a in SELs.
Methods
This study analyzed data of patients who underwent EUS-TA using HEP1p1a between January 2019 and May 2025. The primary outcome was pathological differentiation. Furthermore, clinical data of EUS-TA using HEP1p1a were compared with those using HEP and other than 1p1a; subgroup analysis was performed comparing the clinical outcomes between SELs ≥20 and <20 mm.
Results
Thirty-six patients underwent EUS-TA using HEP1p1a (technical success rate: 100%): 24 and 12 patients with lesions ≥20 and <20 mm, respectively. The rates of achieving pathological differentiation, immunohistochemical success, and definitive histologic diagnosis were 94.4%, 89.3%, and 86.1%, respectively; for SELs ≥20 mm, they were 100%, 94.7%, and 95.8%, respectively. Cellularity and maximum length of white sequential specimens were better in patients with lesions ≥20 mm. No adverse events were observed during or after the procedures.
Conclusions
High diagnostic performance and specimen quality were demonstrated with EUS-TA using HEP1p1a for SELs, particularly those >20 mm. To acquire high-quality specimens while minimizing blood contamination, EUS-TA with HEP1pla for SELs might be an effective approach.

322 View
66 Download

Short-term outcome of endoscopic submucosal dissection using a clutch cutter for subepithelial lesions within the esophagogastric submucosa: a Japanese prospective observational study: Kazuya Akahoshi, Kazuki Inamura, Kazuaki Akahoshi, Shigeki Osada, Shinichi Tamura, Yoshihiro Oishi, Masafumi Oya, Hidenobu Koga; Clin Endosc 2025;58(2):278-284. Published online October 10, 2024; DOI: https://doi.org/10.5946/ce.2024.094

Graphical Abstract Abstract PDF Supplementary Material

Background
/Aims: The efficacy and safety of endoscopic submucosal dissection using a clutch cutter (ESD-CC) for subepithelial lesions within the esophagogastric submucosa (SELEGSM) has not been investigated. This study aimed to assess the efficacy and safety of ESD-CC for the treatment of SELEGSM.
Methods
This prospective study included 15 consecutive patients with 18 SELEGSMs diagnosed by endoscopic ultrasonography. The primary outcomes were short-term outcomes including en bloc resection rate, R0 resection rate, procedure time, and complication rate. The secondary outcome was final histological diagnosis.
Results
Among the participants, 18 lesions were identified: 12 in the stomach (nine patients) and six in the esophagus (six patients). The en bloc resection rate was 94.4% (17/18). The R0 resection rate was 88.9% (16/18). The median operating time was 39 min, and no instances of perforation or bleeding were observed. The final diagnoses of SELEGSM included six neuroendocrine tumors (33.3%), six granular cell tumors (33.3%), two ectopic pancreases (11.1%), one inflammatory fibroid polyp (5.6%), one leiomyoma (5.6%), one lipoma (5.6%), and one leiomyosarcoma (5.6%).
Conclusions
ESD-CC appears to be a technically efficient and safe approach for SELEGSM resection, suggesting its potential as a valuable treatment option.

Citations

Citations to this article as recorded by

Clinical efficacy of endoscopic resection for subepithelial tumors in the esophagogastric junction and gastric cardia: an observational study
Sang Jin Park, Min A Yang, Jae Sun Song, Won Dong Lee, Myoung Jin Ju, Jin Woong Cho
Clinical Endoscopy.2026; 59(2): 245. CrossRef
Endoscopic Submucosal Dissection for Gastric Neoplasia: Scoping Review with ☸️SAIMSARA

SAIMSARA Journal.2026;[Epub] CrossRef
Advancements in endoscopic resection of subepithelial tumors: toward safer, recurrence-free techniques
Won Shik Kim, Moon Kyung Joo
Clinical Endoscopy.2025; 58(2): 256. CrossRef

6,504 View
312 Download
2 Web of Science
3 Crossref

Prevalence, natural progression, and clinical practices of upper gastrointestinal subepithelial lesions in Korea: a multicenter study: Younghee Choe, Yu Kyung Cho, Gwang Ha Kim, Jun-Ho Choi, Eun Soo Kim, Ji Hyun Kim, Eun Kwang Choi, Tae Hyeon Kim, Seong-Hun Kim, Do Hoon Kim, The Research Group for Endoscopic Ultrasound in Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2023;56(6):744-753. Published online August 25, 2023; DOI: https://doi.org/10.5946/ce.2023.005

Graphical Abstract Abstract PDF

Background
/Aims: This study aimed to evaluate the prevalence and natural progression of subepithelial lesions (SELs) in the upper gastrointestinal (UGI) tract.
Methods
The medical records of patients with UGI SELs who underwent endoscopic screening at eight university hospitals between January and December 2010 were retrospectively investigated. The follow-up evaluations were performed until December 2016.
Results
UGI SELs were found in 1,044 of the 65,233 participants screened (endoscopic prevalence, 1.60%; the total number of lesions, 1,062; mean age, 55.1±11.2 years; men, 53.6%). The median follow-up period was 48 (range, 8–74) months. SELs were most frequently found in the stomach (63.8%) and had a mean size of 9.9±6.1 mm. Endoscopic ultrasonography (EUS) was performed in 293 patients (28.1%). The most common lesions were leiomyomas, followed by gastrointestinal stromal tumors (GISTs), and ectopic pancreas. The proportions of SELs with malignant potential according to size were 3% (<1 cm), 22% (1–2 cm), 27% (2–3 cm), and 38% (≥3 cm). In gastric SELs larger than 1 cm, resections were performed in 20 patients because of an increase in size, of which 12 were found to be GISTs.
Conclusions
The prevalence of UGI SELs was 1.60%. Further, 23% of gastric SELs ≥1 cm were precancerous lesions, most followed by EUS and clinical decisions without initial pathological confirmation.

Citations

Citations to this article as recorded by

Endoscopic Diagnosis of Gastric Subepithelial Lesions < 20 mm: Current Strategies and Emerging Solutions
Yosuke Minoda, Shuzaburo Nagatomo, Haruei Ogino, Nao Fujimori, Eikichi Ihara
Digestive Endoscopy.2026;[Epub] CrossRef
Contrast-Enhanced Harmonic Endoscopic Ultrasonography for Diagnosing Gastric Subepithelial Tumors
Moon Won Lee, Dong Chan Joo, Gwang Ha Kim, Bong Eun Lee, Hye Kyung Jeon
Diagnostics.2026; 16(1): 165. CrossRef
Prevalence of potentially malignant lesions in small gastric subepithelial lesions undergoing surgical resection according to the risk features
Sung Eun Kim, Mi Ran Jung
Foregut Surgery.2026; 6(1): 18. CrossRef
Recent advancement in size measurement during endoscopy
Hye Kyung Jeon, Gwang Ha Kim
Clinical Endoscopy.2026; 59(1): 1. CrossRef
Endoscopic and Hybrid Approaches for Gastric Subepithelial Tumors: Expanding the Frontiers of Minimally Invasive Therapy
Francesco Bombaci, Angelo Bruni, Michele Dota, Massimo Del Gaudio, Giuseppe Dell’Anna, Francesco Vito Mandarino, Francesco Azzolini, Emanuele Sinagra, Lorenzo Fuccio, Rocco Maurizio Zagari, Giovanni Barbara, Paolo Cecinato
Gastroenterology Insights.2026; 17(1): 13. CrossRef
Natural History of Gastric Subepithelial Lesions Measuring 1 to 2 cm
Younghee Choe, Byung-Wook Kim, Soo-Young Na, Joon Sung Kim
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2026; 26(1): 79. CrossRef
Long-term prognosis and risk factor-based surveillance strategy for patients with small gastric subepithelial lesion using endoscopic ultrasonography
Jong Sun Park, Ji Hyun Park, Bumhee Park, Jong Hoon Park, Sun Gyo Lim, Sung Jae Shin, Kee Myung Lee, Sung Soo Ahn, Choong-Kyun Noh, Gil Ho Lee
Endoscopic Ultrasound.2026; 15(1): 62. CrossRef
Clinical efficacy of endoscopic resection for subepithelial tumors in the esophagogastric junction and gastric cardia: an observational study
Sang Jin Park, Min A Yang, Jae Sun Song, Won Dong Lee, Myoung Jin Ju, Jin Woong Cho
Clinical Endoscopy.2026; 59(2): 245. CrossRef
CAD-SEL: A dual-modal colonoscopy dataset of subepithelial lesion
Louzhe Xu, Shurong Chen, Chunxiao Li, Jingjing Zhou, Xiaohan Shen, Jinghua Wang, Xinjue He, Tianlian Yan, Han Ma, Yizhen Zhang, Lan Li, Shu Bian, Yue Huang, Chao Lu, Yangyang Xiong, Jiang Liu, Qiang Chen, Lina Ye, Qiaona He, Yini Ke, Youming Li, Xinli Mao
Scientific Data.2026;[Epub] CrossRef
Diagnosis and Management of Asymptomatic Upper Gastrointestinal Subepithelial Lesions
Yonghoon Choi
The Korean Journal of Gastroenterology.2026; 86(3): 139. CrossRef
How should we manage incidental gastric subepithelial lesions?
Sung Eun Kim
Clinical Endoscopy.2026; 59(4): 685. CrossRef
Natural History of Upper Gastrointestinal Subepithelial Tumors
Seokin Kang
Journal of Digestive Cancer Research.2026; 14(2): 139. CrossRef
Natural history of asymptomatic subepithelial lesions of the upper gastrointestinal tract: A multicenter study in Korea
Yonghoon Choi, Jae Yong Park, Sung Eun Kim, Jae Myung Park, Joon Sung Kim, Hyunsoo Chung, Seung Han Kim, Chan Hyuk Park, Sang Hoon Kim, Seon-Young Park, Bong Eun Lee, Seung Woo Lee, Ayoung Lee, Jeong Hoon Lee, Da Hyun Jung, Hyeong Ho Jo, In Hyuk Yoo, Byun
World Journal of Gastroenterology.2026;[Epub] CrossRef
The efficacy and safety of submucosal tunneling endoscopic resection in treating large esophageal subepithelial lesions
Huiting Lin, Songfeng Chen, Niandi Tan, Qianjun Zhuang, Xingyu Jia, Dianxuan Jiang, Yinglian Xiao, Jinhui Wang
Surgical Endoscopy.2025; 39(3): 1672. CrossRef
Natural Course and Long-Term Outcomes of Gastric Subepithelial Lesions: A Systematic Review
Masaya Iwamuro, Hiroyuki Okada, Motoyuki Otsuka
Journal of Clinical Medicine.2025; 14(4): 1055. CrossRef
Rapidly Growing Gastrointestinal Stromal Tumor on the Esophagus
Ji Hye Park, Sung Eun Kim, Seun Ja Park, Moo In Park, Won Moon, Jae Hyun Kim, Kyoungwon Jung, Myung Hun Lee
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2025; 25(1): 64. CrossRef
Advancements in Endoscopic Treatment for Gastric Subepithelial Tumors
Osamu Goto, Kazutoshi Higuchi, Eriko Koizumi, Katsuhiko Iwakiri
Gut and Liver.2025; 19(2): 151. CrossRef
Endoscopic mucosal resection of a large duodenal polyp
Ye Rin Chae, Ga Hee Kim
Clinical Endoscopy.2025; 58(2): 331. CrossRef
Diagnostic accuracy and influencing factors of microprobe endoscopic ultrasound for gastrointestinal subepithelial lesions: a multicenter retrospective study
Jiao Li, Yongfeng Yan, Dandan Jiang, Xiaoxiang Wang, Li Wang, Li Liu, Tao Shu, Zhengkui Zhou, Xiaobin Sun
BMC Gastroenterology.2025;[Epub] CrossRef
Natural History of Gastric Subepithelial Tumors: Long-Term Outcomes and Surveillance Strategies
Hye Kyung Jeon, Gwang Ha Kim
Journal of Clinical Medicine.2025; 14(18): 6354. CrossRef
Natural Course of Gastric Subepithelial Tumors
Ji Yoon Kim, Seung Joo Kang
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2025; 25(3): 224. CrossRef
Approach to Gastric Subepithelial Lesions: From Differential Diagnosis to Histologic Confirmation
Sang Hoon Kim
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2025; 25(3): 209. CrossRef
Gastric cancer with lymphoid stroma mimicking a subepithelial lesion after a 10-year disease-free interval: a case report
Bang Ju Kim, Sung Eun Kim, Seun Ja Park, Moo In Park, Won Moon, Jae Hyun Kim, Kyoungwon Jung, Myung Hun Lee, Jung Wook Lee, Kyung Won Seo, Hee-Kyung Chang
Kosin Medical Journal.2025; 40(3): 233. CrossRef
Outcomes of device assisted endoscopic full thickness resection in gastroduodenal submucosal lesions: A large, multicentre study (with videos)
Zaheer Nabi, Gaurav Patil, Rajesh Puri, Truptesh Kothari, Sukrit Sud, Radhika Chavan, Sridhar Sundaram, Nikhil Sonthalia, Jimmy Narayana, Jayanta Samanta, Jahnvi Dhar, Sanjay Rajput, Vikas Singla, Jeff George, Pankaj Dhawan, Rajesh Goud, Pradev Inavolu, A
Digestive and Liver Disease.2025; 57(12): 2435. CrossRef
Assessing the utility of three-dimensional imaging for preoperative assessment of gastric subepithelial tumors
Dong Chan Joo, Gwang Ha Kim
Clinical Endoscopy.2025; 58(6): 854. CrossRef
A Case of Esophageal MALT Lymphoma Mimicking a Subepithelial Tumor
Ha Eun Lee, Gwang Ha Kim, Min Ji Kim, Kyung Bin Kim, Dong Chan Joo, Hye Kyung Jeon, Moon Won Lee, Bong Eun Lee
The Korean Journal of Gastroenterology.2024; 83(4): 157. CrossRef
Small gastric subepithelial lesions: A sand in the eye
Tanyaporn Chantarojanasiri, Nikhil Sonthalia, Rashid N. Lui
Journal of Gastroenterology and Hepatology.2024; 39(7): 1207. CrossRef
Endoscopic treatment of a large Brunner’s gland hamartoma in the duodenum
Ha Eun Lee, Gwang Ha Kim, Kyungbin Kim
Endoscopy.2024; 56(S 01): E546. CrossRef
Artificial Intelligence-Based Diagnosis of Gastric Mesenchymal Tumors Using Digital Endosonography Image Analysis
Dong Chan Joo, Gwang Ha Kim, Moon Won Lee, Bong Eun Lee, Ji Woo Kim, Kwang Baek Kim
Journal of Clinical Medicine.2024; 13(13): 3725. CrossRef
An Esophageal Leiomyoma with Cystic Degeneration Mimicking a Malignant Neoplasm
Gwang Ha Kim, Dong Chan Joo, Moon Won Lee, Bong Eun Lee, Kyungbin Kim
The Ewha Medical Journal.2023;[Epub] CrossRef

9,205 View
289 Download
25 Web of Science
30 Crossref

Systematic Review and Meta-Analysis

Mucosal incision-assisted biopsy versus endoscopic ultrasound-assisted tissue acquisition for subepithelial lesions: a systematic review and meta-analysis: Suprabhat Giri, Shivaraj Afzalpurkar, Sumaswi Angadi, Sridhar Sundaram; Clin Endosc 2022;55(5):615-625. Published online August 4, 2022; DOI: https://doi.org/10.5946/ce.2022.133

Abstract PDF Supplementary Material

Background
/Aims: Mucosal incision-assisted biopsy (MIAB) for tissue acquisition (TA) from subepithelial lesions (SELs) is emerging as an alternative to endoscopic ultrasound (EUS)-guided TA. Only a limited number of studies compared the diagnostic utility of MIAB and EUS for upper gastrointestinal (GI) SELs; therefore, we conducted this systematic review and meta-analysis.
Methods
A comprehensive literature search from January 2020 to January 2022 was performed to compare the diagnostic accuracy and safety of MIAB and EUS-guided TA for upper GI SELs.
Results
Seven studies were included in this meta-analysis. The pooled technical success rate (risk ratio [RR], 0.96; 95% confidence interval [CI], 0.89–1.04) and procedural time (mean difference=–4.53 seconds; 95% CI, –22.38 to 13.31] were comparable between both the groups. The overall chance of obtaining a positive diagnostic yield was lower with EUS than with MIAB for all lesions (RR, 0.83; 95% CI, 0.71–0.98) but comparable when using a fine-needle biopsy needle (RR, 0.93; 95% CI, 0.83–1.04). The positive diagnostic yield of MIAB was higher for lesions <20 mm (RR, 0.75; 95% CI, 0.63–0.89). Six studies reported no adverse events.
Conclusions
MIAB can be considered an effective alternative to EUS-guided TA for upper GI SELs without an increased risk of adverse events.

Citations

Citations to this article as recorded by

Endoscopic Diagnosis of Gastric Subepithelial Lesions < 20 mm: Current Strategies and Emerging Solutions
Yosuke Minoda, Shuzaburo Nagatomo, Haruei Ogino, Nao Fujimori, Eikichi Ihara
Digestive Endoscopy.2026;[Epub] CrossRef
Population-Based Efficacy of Tissue Acquisition for Subepithelial Lesions in the Upper Gastrointestinal Tract
Cynthia A. Verloop, Lieke Hol, Lars Perk, Femme Dircksmeier-Harinck, Pieter Honkoop, Tessa Romkens, Ingrid Schot, Jilling Bergmann, Rutger Quispel, Marco J. Bruno, Lydi M.J.W. van Driel
Journal of Clinical Gastroenterology.2026;[Epub] CrossRef
Upfront unroofing of subepithelial lesions using cold snare in the upper and lower gastrointestinal tract: a retrospective study from Switzerland
Bernhard Morell, Jasmina El Hadad-Burla, Frans Olivier The, Fabian Reinisch, Christoph Gubler, Fritz Ruprecht Murray
Clinical Endoscopy.2026; 59(4): 633. CrossRef
S2k-Leitlinie Qualitätsanforderungen in der gastrointestinalen Endoskopie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS)

Zeitschrift für Gastroenterologie.2026; 64(08): 1139. CrossRef
Diagnostic ability and adverse events of mucosal incision‐assisted biopsy for gastric subepithelial tumors: Systematic review and meta‐analysis
Eriko Koizumi, Osamu Goto, Akihisa Matsuda, Toshiaki Otsuka, Yumiko Ishikawa, Shun Nakagome, Masahiro Niikawa, Tsugumi Habu, Keiichiro Yoshikata, Kumiko Kirita, Hiroto Noda, Kazutoshi Higuchi, Takeshi Onda, Jun Omori, Naohiko Akimoto, Hiroshi Yoshida, Kat
Digestive Endoscopy.2025; 37(3): 236. CrossRef
Current Management Strategies for Patients with Gastrointestinal and Pulmonary Neuroendocrine Tumors
Yulia V. Mikheeva, Pavel O. Rumyantsev, Konstantin K. Puzakov, Konstantin Yu. Slashchuk, Daniil D. Omelchuk, Anastasia V. Potapenko, Sergey P. Medvedev
Russian Journal of Oncology.2025; 30(1): 41. CrossRef
Approach to upper gastrointestinal subepithelial lesions
Shrihari Anil Anikhindi, Rajesh Puri, Noriya Uedo, Kamlesh Taori, Anil Arora
Expert Review of Gastroenterology & Hepatology.2025; 19(7): 789. CrossRef
Diagnostic challenges of inflammatory submucosal tumor-like lesions: a multicenter propensity score-matching analysis
Mengting Yu, Jiao Li, Yongfeng Yan, Xiaoxiang Wang, Yanhui Mao, Dandan Jiang, Zhengkui Zhou, Yuanyuan Chen, Xiaobin Sun
BMC Gastroenterology.2025;[Epub] CrossRef
Technical outcomes and postprocedural courses of mucosal incision‐assisted biopsy for possible gastric gastrointestinal stromal tumors: A series of 48 cases (with video)
Eriko Koizumi, Osamu Goto, Shun Nakagome, Tsugumi Habu, Yumiko Ishikawa, Kumiko Kirita, Hiroto Noda, Kazutoshi Higuchi, Takeshi Onda, Teppei Akimoto, Jun Omori, Naohiko Akimoto, Katsuhiko Iwakiri
DEN Open.2024;[Epub] CrossRef
The Diagnostic Approach of Benign Esophageal Tumors: A Narrative Review
Alex R. Jones, Preksha Vankawala, Tarek Sawas
Current Treatment Options in Gastroenterology.2024; 22(2): 44. CrossRef
Unroofing of subepithelial lesions in the upper gastrointestinal tract using cold snare: an easy and efficient technique for diagnosis
Bernhard Morell, Frans Olivier The, Christoph Gubler, Fritz Ruprecht Murray
Clinical Endoscopy.2024; 57(2): 274. CrossRef
Diagnostic yield of endoscopic and EUS-guided biopsy techniques in subepithelial lesions of the upper GI tract: a systematic review
Cynthia A. Verloop, Jacqueline A.C. Goos, Marco J. Bruno, Rutger Quispel, Lydi M.J.W. van Driel, Lieke Hol
Gastrointestinal Endoscopy.2024; 99(6): 895. CrossRef
Small gastric subepithelial lesions: A sand in the eye
Tanyaporn Chantarojanasiri, Nikhil Sonthalia, Rashid N. Lui
Journal of Gastroenterology and Hepatology.2024; 39(7): 1207. CrossRef
EUS‐guided tissue acquisition from gastric subepithelial lesions—The optimal technique still remains undecided
Suprabhat Giri, Sridhar Sundaram
Australasian Journal of Ultrasound in Medicine.2024; 27(4): 263. CrossRef
Endoscopic Ultrasound and Gastric Sub-Epithelial Lesions: Ultrasonographic Features, Tissue Acquisition Strategies, and Therapeutic Management
Marzia Varanese, Marco Spadaccini, Antonio Facciorusso, Gianluca Franchellucci, Matteo Colombo, Marta Andreozzi, Daryl Ramai, Davide Massimi, Roberto De Sire, Ludovico Alfarone, Antonio Capogreco, Roberta Maselli, Cesare Hassan, Alessandro Fugazza, Alessa
Medicina.2024; 60(10): 1695. CrossRef
Efficacy of EUS-guided keyhole biopsies in diagnosing subepithelial lesions of the upper gastrointestinal tract
Sen Verhoeve, Cynthia Verloop, Marco Bruno, Valeska Terpstra, Lydi Van Driel, Lars Perk, Lieke Hol
Endoscopy International Open.2024; 12(10): E1183. CrossRef
Approach to Small Gastric Subepithelial Lesions
Moon Won Lee, Bong Eun Lee
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2023; 23(1): 28. CrossRef
Is the canalization to obtain deep biopsy of gastrointestinal subepithelial tumors miniprobe-guidded as an alternative to conventional known techniques?
Modesto Varas Lorenzo, Ramón Abad Belando
Revista Española de Enfermedades Digestivas.2023;[Epub] CrossRef
Role of Advanced Gastrointestinal Endoscopy in the Comprehensive Management of Neuroendocrine Neoplasms
Harishankar Gopakumar, Vinay Jahagirdar, Jagadish Koyi, Dushyant Singh Dahiya, Hemant Goyal, Neil R. Sharma, Abhilash Perisetti
Cancers.2023; 15(16): 4175. CrossRef

7,622 View
175 Download
14 Web of Science
19 Crossref

Case Report

Endoscopic Full-Thickness Resection for Gastric Subepithelial Lesions Arising from the Muscularis Propria: Ah Lon Jung, Sang Wook Park, Gun Young Hong, Hyeong Chul Moon, Seo Joon Eun; Clin Endosc 2021;54(1):131-135. Published online August 21, 2020; DOI: https://doi.org/10.5946/ce.2020.070

Abstract PDF

Most cases of gastric subepithelial lesions follow a good clinical course; however, some lesions progress to malignant tumors, and treatment of tumors with a high risk of malignancy is essential. Surgical excision has been the primary treatment for tumors originating from the propria muscle layer, but it has the disadvantages of being invasive and causing postoperative functional abnormalities. With the development of endoscopic techniques and instruments, the role of endoscopic resection, which is a less invasive method for the removal of gastric subepithelial lesions, has been attracting attention. We performed an endoscopic full-thickness resection for 8 patients with gastric subepithelial lesions originating from the muscularis propria. No fatal complications occurred. Our findings suggest the need to develop various devices for resection and closure and to accumulate further experience through additional studies to prevent complications and specimen loss.

Citations

Citations to this article as recorded by

Advances in endoscopic closure techniques for endoscopic full-thickness resection
Meng Zhang, Jiao Liu, Jiang-Ning Gu, Ke Han, Wen Jia, Peng Li, Yong Sun, Na An, Zhuo Yang
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Robotic Platforms for Therapeutic Flexible Endoscopy: A Literature Review
Naoya Tada, Kazuki Sumiyama
Diagnostics.2024; 14(6): 595. CrossRef
Advances of endoscopic and surgical management in gastrointestinal stromal tumors
Lei Yue, Yingchao Sun, Xinjie Wang, Weiling Hu
Frontiers in Surgery.2023;[Epub] CrossRef
Current Status of Endoscopic Full-Thickness Resection for Gastric Subepithelial Tumors: A Literature Review Over Two Decades
Naoya Tada, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Tsutomu Masaki, Noriya Uedo
Digestion.2023; 104(6): 415. CrossRef
Endoscopic Full Thickness Resection: A Systematic Review
Partha Pal, Mohan Ramchandani, Pradev Inavolu, Duvvuru Nageshwar Reddy, Manu Tandan
Journal of Digestive Endoscopy.2022; 13(03): 152. CrossRef

8,058 View
139 Download
5 Web of Science
5 Crossref

Review

Colorectal Subepithelial Lesions: Tae Oh Kim; Clin Endosc 2015;48(4):302-307. Published online July 24, 2015; DOI: https://doi.org/10.5946/ce.2015.48.4.302

Abstract PDF

Most of subepithelial lesion (SEL) being identified was accidentally discovered as small bulging lesion covered with normal mucosa from endoscopic screening. The type of treatment and prognosis vary depending on the type of tumor, it would be crucial to perform an accurate differential diagnosis. Since the differentiation of SEL relied on the indirect findings observed from the mucosal surface using an endoscopy only in the past, it was able to confirm the presence of lesion only but difficult to identify complex detailed nature of the lesion. However, after the endoscopic ultrasonography (EUS) was introduced, it became possible to identify extrinsic compression, and size of intramural tumors, internal properties and contour so that it gets possible to have differential diagnosis of lesions and prediction on the lesion whether it is malignant or benign. In addition, the use of EUS-guided fine needle aspiration and EUS-guided core biopsy made it possible to make histological differential diagnosis. This study intended to investigate endoscopic and EUS findings, histological diagnosis, treatment regimen and impression of colorectal SELs.

Citations

Citations to this article as recorded by

Characteristics and diagnostic sensitivity of endoscopic ultrasound in lower gastrointestinal subepithelial lesions
Yu-Shiuan Liang, Li-Chun Chang, Weng-Fai Wong, Ming-Lun Han, Chieh-Chang Chen, Chien-Chuan Chen, Ping-Huei Tseng
Journal of the Formosan Medical Association.2026;[Epub] CrossRef
Combined use of EUS, ESD, and laparoscopic techniques in the diagnosis and treatment of a mucinous adenocarcinoma of the ascending colon originating from the submucosal layer: a case report
Zongyao Liu, Yanling Li, Rong Tan, Ainizhati Abudusaimaiti, Shengjuan Hu, Ximei Li
Frontiers in Physiology.2026;[Epub] CrossRef
Upfront unroofing of subepithelial lesions using cold snare in the upper and lower gastrointestinal tract: a retrospective study from Switzerland
Bernhard Morell, Jasmina El Hadad-Burla, Frans Olivier The, Fabian Reinisch, Christoph Gubler, Fritz Ruprecht Murray
Clinical Endoscopy.2026; 59(4): 633. CrossRef
Bite-on-Bite Near Miss: From Hemangioma to Gastrointestinal Stromal Tumors
Olivia Reszczynski, Himesh B. Zaver, Dev Patel, Christopher Farid, Steven Powell, Daniel S. Strand
ACG Case Reports Journal.2026;[Epub] CrossRef
A Rare Subepithelial Lesion of the Proximal Colon Evaluated Using Miniprobe Endoscopic Ultrasonography: A Case Report
Hidetaka Hamamoto, Tomoki Matsuda, Mareyuki Endo
Cureus.2025;[Epub] CrossRef
Clinicopathologic and Endosonographic Characteristics of Colon Subepithelial Tumors Discovered Incidentally
Aryoung Kim, Sung Noh Hong, Dong Kyung Chang, Young-Ho Kim, Ji Eun Kim, Eun Ran Kim
Diagnostics.2024; 14(5): 551. CrossRef
Prone Jack-Knife Transanal Minimally Invasive Surgery: A Safe and Effective Approach for Anterior Low Rectal GI Stromal Tumors
Jothinathan Muniandy, Cheng-Wei Huang, Tao-Wei Ke, William Tzu-Liang Chen
Diseases of the Colon & Rectum.2024; 67(5): e291. CrossRef
Colonoscopy-assisted laparoscopic wedge resection for a large symptomatic colonic lipoma
Julia Hanevelt, Wouter Hugo de Vos Tot Nederveen Cappel, Fiebo Johannes Cornelis ten Kate, Henderik Leendert van Westreenen
BMJ Case Reports.2024; 17(4): e258947. CrossRef
Penile Prosthetic Pump Reservoir Mimicking a Cecal Subepithelial Mass
Prince Addo Ameyaw, Harry R. Aslanian
ACG Case Reports Journal.2024; 11(7): e01413. CrossRef
Aggressive fibromatosis of the sigmoid colon: A case report
Pan-Pan Yu, Xin-Chun Liu, Lu Yin, Guang Yin
World Journal of Gastrointestinal Oncology.2024; 16(8): 3716. CrossRef
A Review of Colonoscopy in Intestinal Diseases
Seung Hong, Dong Baek
Diagnostics.2023; 13(7): 1262. CrossRef
Application of rubber band and clip traction for removal of a submucosal fecalith mimicking a submucosal tumor of the appendix under colonoscopy
Longping Chen, Linfu Zheng, Zhiping Chen, Dazhou Li, Wen Wang
Endoscopy.2023; 55(S 01): E835. CrossRef
Az alsó tápcsatornai endoszkópos ultrahangvizsgálat
Anna Fábián, Renáta Bor, Zsófia Bősze, Tibor Tóth, Péter Bacsur, Anita Bálint, Klaudia Farkas, Tamás Resál, Mariann Rutka, Tamás Molnár, Zoltán Szepes
Orvosi Hetilap.2023; 164(30): 1176. CrossRef
Spontaneous regression of a rectal tonsil presenting as a large submucosal tumor
Toru Matsui, Eri Naitoh, Kengo Furutani, Tomoji Katoh, Katsuya Kobayashi, Kenichiro Sekigawa, Hiroshi Mitsui
DEN Open.2022;[Epub] CrossRef
Endoscopic submucosal dissection of a small rectal submucosal lesion: a rare case of rectal liposarcoma
Lucile Héroin, Pierre Lafeuille, Thomas Lambin, Pierre Mayer, Martin Bordet, Florian Rostain, Mathieu Pioche
Endoscopy.2022; 54(09): E504. CrossRef
An Atypical Presentation of a Colonic Lipoma: Avoiding Surgery with a Deeper Endoscopic Look
Mafalda João, Inês Cunha, Elisa Gravito-Soares, Marta Gravito-Soares, Pedro Amaro, Pedro Figueiredo
GE - Portuguese Journal of Gastroenterology.2022; 29(1): 45. CrossRef
EUS and EUS-guided FNA/core biopsies in the evaluation of subepithelial lesions of the lower gastrointestinal tract: 10-year experience
IrinaM Cazacu, BenS Singh, AdrianaA Luzuriaga Chavez, Pramoda Koduru, Shamim Ejaz, BrianR Weston, WilliamA Ross, JeffreyH Lee, Sinchita Roy-Chowdhuri, ManoopS Bhutani
Endoscopic Ultrasound.2020; 9(5): 329. CrossRef
Cellular Angiofibroma Presenting as a Subepithelial Rectal Mass
Jennifer Bloom, Eric Jordan, Vanessa M. Baratta, Xuchen Zhang, Atin Saha, George Yavorek, Vadim Kurbatov
ACG Case Reports Journal.2020; 7(11): e00471. CrossRef
Should We Collect a Biopsy From This Submucosal Lesion in the Cecum?
Paul Vincent Co, Richard Benya, Mukund Venu
Gastroenterology.2019; 156(1): 34. CrossRef
Rectal Endoscopic Ultrasound in Clinical Practice
Stephen Hasak, Vladimir Kushnir
Current Gastroenterology Reports.2019;[Epub] CrossRef
Current Status of Endoscopic Ultrasonography in Gastrointestinal Subepithelial Tumors
Sang Gyun Kim, Ji Hyun Song, Joo Ha Hwang
Clinical Endoscopy.2019; 52(4): 301. CrossRef
Radial Endoscopic Ultrasound for the Diagnosis of Chronic Schistosomiasis in the Colorectum
Chun-Hua Zhou, Wei-Xia Zhou, Duan-Min Hu
Clinical Gastroenterology and Hepatology.2017; 15(10): e151. CrossRef
Highlights from the 52nd Seminar of the Korean Society of Gastrointestinal Endoscopy
Eun Young Kim, Il Ju Choi, Kwang An Kwon, Ji Kon Ryu, Ki Baik Hahm
Clinical Endoscopy.2015; 48(4): 269. CrossRef

16,706 View
271 Download
22 Web of Science
23 Crossref

Original Article

Concordance of Endoscopic Ultrasonography-Guided Fine Needle Aspiration Diagnosis with the Final Diagnosis in Subepithelial Lesions: Erkan Çağlar, İbrahim Hatemi, Deniz Atasoy, Gürhan Şişman, Hakan Şentürk; Clin Endosc 2013;46(4):379-383. Published online July 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.4.379

Abstract PDF

Background/Aims

In this study we aimed to determine the rate of concordance of endoscopic ultrasonography (EUS)-guided fine needle aspiration (FNA) diagnosis with the final diagnosis obtained by surgery or endoscopic resection and follow-up in upper gastrointestinal subepithelial lesions.

Methods

We retrospectively studied patients with subepithelial lesions who underwent EUS at our center from 2007 to 2011.

Results

We had a final diagnosis in 67 patients (mean age±SD, 51.23±12.48 years; 23 [34.3%] female, 44 [65.6%] male). EUS-FNA was performed in all of the patients. On-site pathology was not performed. In nine of the patients, the obtained material which was obtained was insufficient. The cytologic examination was benign in 31 and malignant in 27 of the patients. Based on the final diagnosis, the EUS-FNA had a sensitivity of 96%, a specificity of 100%, and a diagnostic yield of 85%.

Conclusions

The diagnostic yield of EUS-FNA, in the absence of the on-site cytopathologist, is feasible for the diagnosis of subepithelial lesions of the upper gastrointestinal system.

Citations

Citations to this article as recorded by

Practice Guidelines for the Diagnosis and Treatment of Subepithelial Lesion Observed in Upper Gastrointestinal Endoscopy
Beom Jin Kim, Seung Joo Kang, Su Youn Nam, Chang Seok Bang, Byung‐Hoon Min, Sung Eun Kim, Seung Young Kim, Hyunchul Lim, Chung Hyun Tae, Moon Won Lee, Seung Han Kim, Sang Hoon Kim, Jong Yeul Lee, Byung‐Wook Kim, Jeong Seop Moon, Jong‐Jae Park, Hwoon‐Yong
Journal of Gastroenterology and Hepatology.2026; 41(2): 488. CrossRef
The role of artificial intelligence and deep learning in determining the histopathological grade of pancreatic neuroendocrine tumors by using EUS images
Sercan Kiremitci, Gulseren Seven, Gokhan Silahtaroglu, Koray Kochan, Serife Degirmencioglu Tosun, Hakan Senturk
Endoscopic Ultrasound.2025; 14(2): 48. CrossRef
Practice Guidelines for the Diagnosis and Treatment of Subepithelial Lesions Observed in Upper Gastrointestinal Endoscopy
Beom Jin Kim, Seung Joo Kang, Su Youn Nam, Chang Seok Bang, Byung-Hoon Min, Sung Eun Kim, Seung Young Kim, Hyunchul Lim, Chung Hyun Tae, Moon Won Lee, Seung Han Kim, Sang Hoon Kim, Jong Yeul Lee, Byung-Wook Kim, Jeong Seop Moon, Jong-Jae Park, Hwoon-Yong
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2025; 25(3): 234. CrossRef
Diagnostic yield of endoscopic and EUS-guided biopsy techniques in subepithelial lesions of the upper GI tract: a systematic review
Cynthia A. Verloop, Jacqueline A.C. Goos, Marco J. Bruno, Rutger Quispel, Lydi M.J.W. van Driel, Lieke Hol
Gastrointestinal Endoscopy.2024; 99(6): 895. CrossRef
Clinical course of asymptomatic duodenal subepithelial lesions
Seokin Kang, Kwangbeom Park, Do Hoon Kim, Yuri Kim, Hee Kyong Na, Jeong Hoon Lee, Ji Yong Ahn, Kee Wook Jung, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
The Korean Journal of Internal Medicine.2024; 39(4): 603. CrossRef
Use of Artificial Intelligence in the Prediction of Malignant Potential of Gastric Gastrointestinal Stromal Tumors
Gulseren Seven, Gokhan Silahtaroglu, Koray Kochan, Ali Tuzun Ince, Dilek Sema Arici, Hakan Senturk
Digestive Diseases and Sciences.2022; 67(1): 273. CrossRef
Natural History of Asymptomatic Esophageal Subepithelial Tumors of 30 mm or Less in Size
Seokin Kang, Do Hoon Kim, Yuri Kim, Dongsub Jeon, Hee Kyong Na, Jeong Hoon Lee, Ji Yong Ahn, Kee Wook Jung, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
Journal of Korean Medical Science.2022;[Epub] CrossRef
Differentiating Gastrointestinal Stromal Tumors from Leiomyomas Using a Neural Network Trained on Endoscopic Ultrasonography Images
Gulseren Seven, Gokhan Silahtaroglu, Ozden Ozluk Seven, Hakan Senturk
Digestive Diseases.2022; 40(4): 427. CrossRef
Subepithelial esophageal tumors: a single-center review of resected and surveilled lesions
Don C. Codipilly, Hongfei Fang, Jeffrey A. Alexander, David A. Katzka, Karthik Ravi
Gastrointestinal Endoscopy.2018; 87(2): 370. CrossRef
Extra-mucosal enucleation is still a safe and feasible treatment option of giant esophageal leiomyomas
Azhar Perwaiz, Vinay Kumar Shaw, Amanjeet Singh, Adarsh Chaudhary
Indian Journal of Gastroenterology.2018; 37(1): 63. CrossRef
The Role of Endoscopic Ultrasound in the Diagnostic Assessment of Subepithelial Lesions of the Upper Gastrointestinal Tract
Francisca Dias de Castro, Joana Magalhães, Sara Monteiro, Sílvia Leite, José Cotter
GE Portuguese Journal of Gastroenterology.2016; 23(6): 287. CrossRef
Which Needle Is Better for Diagnosing Subepithelial Lesions?
Eun Young Kim
Clinical Endoscopy.2015; 48(2): 91. CrossRef
EUS-guided tissue acquisition: an evidence-based approach (with videos)
Sachin Wani, V. Raman Muthusamy, Srinadh Komanduri
Gastrointestinal Endoscopy.2014; 80(6): 939. CrossRef
Diagnosis of Subepithelial Lesion: Still "Tissue Is the Issue"
Eun Young Kim
Clinical Endoscopy.2013; 46(4): 313. CrossRef

9,588 View
64 Download
14 Crossref

Special Issue Articles of IDEN 2012

Endoscopic Ultrasound, Where Are We Now in 2012?: Eun Young Kim; Clin Endosc 2012;45(3):321-323. Published online August 22, 2012; DOI: https://doi.org/10.5946/ce.2012.45.3.321

Abstract PDF

Topics related with endoscopic ultrasound (EUS) made up considerable portion among many invited lectures presented in International Digestive Endoscopy Network 2012 meeting. While the scientific programs were divided into the fields of upper gastrointestinal (UGI), lower gastrointestinal, and pancreato-biliary (PB) categories, UGI and PB parts mainly dealt with EUS related issues. EUS diagnosis in subepithelial lesions, estimation of the invasion depth of early gastrointestinal cancers with EUS, and usefulness of EUS in esophageal varices were discussed in UGI sessions. In the PB part, pancreatic cystic lesions, EUS-guided biliopancreatic drainage, EUS-guided tissue acquisition, and improvement of diagnostic yield in indeterminate biliary lesions by using intraductal ultrasound were discussed. Advanced techniques such as contrast-enhanced EUS, EUS elastography and forward-viewing echoendoscopy were also discussed. In this paper, I focused mainly on topics of UGI and briefly mentioned about advanced EUS techniques since more EUS related papers by other invited speakers were presented afterwards.

Citations

Citations to this article as recorded by

Diagnostic and Therapeutic Indications for Endoscopic Ultrasound (EUS) in Patients with Pancreatic and Biliary Disease—Novel Interventional Procedures
Manfred Prager, Elfi Prager, Christian Sebesta, Christian Sebesta
Current Oncology.2022; 29(9): 6211. CrossRef
Systematic review of endoscopy ultrasound-guided thermal ablation treatment for pancreatic cancer
SabrinaGloria Giulia Testoni, AndrewJames Healey, ChristophF Dietrich, PaoloGiorgio Arcidiacono
Endoscopic Ultrasound.2020; 9(2): 83. CrossRef
The surgical management of locally advanced well-differentiated thyroid carcinoma: changes over the years according to the AJCC 8th edition Cancer Staging Manual
Alessio Metere, Valerio Aceti, Laura Giacomelli
Thyroid Research.2019;[Epub] CrossRef
Echoendoscopic ablative therapy for solid pancreatic tumors
Woo Hyun Paik, Dong Wan Seo
Journal of Digestive Diseases.2017; 18(3): 135. CrossRef
The Role of Endoscopic Ultrasound in the Diagnostic Assessment of Subepithelial Lesions of the Upper Gastrointestinal Tract
Francisca Dias de Castro, Joana Magalhães, Sara Monteiro, Sílvia Leite, José Cotter
GE Portuguese Journal of Gastroenterology.2016; 23(6): 287. CrossRef
Colorectal Subepithelial Lesions
Tae Oh Kim
Clinical Endoscopy.2015; 48(4): 302. CrossRef

6,869 View
40 Download
6 Crossref

Diagnostic Use of Endoscopic Ultrasound-guided Trucut Biopsy in Various Diseases: Jin Ho Lee, M.D., Jung Hwan Lee, M.D., Jung Hoon Song, M.D., Kyung Sun Ok, M.D., Won Cheol Jang, M.D., Soo Hyung Ryu, M.D., You Sun Kim, M.D. and Jeong Seop Moon, M.D.; Korean J Gastrointest Endosc 2010;40(1):9-15. Published online January 30, 2010

Abstract PDF: Background
/Aims: Endoscopic ultrasound-guided trucut biopsy (EUS-TCB) is a relatively new method, which facilitates obtaining a core biopsy through the gut wall. We evaluated the diagnostic accuracy of EUS-TCB based on the types of lesions.
Methods
We retrospectively reviewed the database of 37 cases in 35 patients (mean age, 57.2±2.3 years; 23 men) with thoracic and abdominal masses who got EUS-TCB between January 2007 and June 2008. Final diagnoses were determined by malignant positive EUS specimens, surgical pathology, or the clinical course.
Results
Adequate samples were obtained by EUS-TCB in 78.4% (29/37) of the cases. The overall diagnostic accuracies of the EUS-TCB were 73.0%. The mean size of the masses was 3.7±2.6 cm. The diagnostic accuracies of EUS-TCB according to the lesions were as follows: lymph node, 85.7% (18/21); subepithelial lesion, 60.0% (6/10); and solid tumor, 50% (3/6). With respect to accuracy, lymph nodes were significantly superior to non-lymph node lesions (p=0.046). There was a minor bleeding controlled by hemoclipping (2.7%).
Conclusions
EUS-TCB is a useful technique for the diagnosis of lymph nodes, subepithelial tumors, and solid tumors that were not able to be diagnosed by other methods. In addition, EUS-TCB is a safe and minimally invasive method. (Korean J Gastrointest Endosc 2010;40:9-15)

2,901 View
9 Download

Catheter Probe Endoscopic Ultrasonography Using the Jelly-Filled Method for Esophageal Subepithelial Lesions: Tae In Ha, M.D., Gwang Ha Kim, M.D., Jae Sup Eum, M.D., Chan Ho Park, M.D., Hyoung Yoel Park, M.D., Cheul Woong Choi, M.D., Kyung Yeob Kim, M.D., Il Du Kim, M.D., Pyo Jun Kim, M.D., Hye Jeong Lee, M.D., Sun Mi Lee, M.D., Tae Oh Kim, M.D., Dae Hwan Kang, M; Korean J Gastrointest Endosc 2008;36(3):125-131. Published online March 30, 2008

Abstract PDF: Background
/Aims: The catheter probe endoscopic ultrasonography (EUS) system is widely used to evaluate upper gastrointestinal tract lesions. The depiction of the esophageal wall by probe EUS remains problematic due to the difficulty of the filling of water in the esophageal lumen. In addition, filling the esophagus with water can be associated with an increased risk of aspiration. To resolve such problems, we recently applied the use of probe EUS with the jelly-filled method for the evaluation of subepithelial lesions. The procedure is characterized by filling the esophageal lumen with jelly. In this study, we evaluated the efficacy of probe EUS by using the jelly-filled method for esophageal subepithelial lesions. Methods: We analyzed the records of the patients with suspected subepithelial lesions at the time of endoscopy that was performed from November 2005 to June 2007. Esophageal subepithelial lesions with both EUS findings and pathological reports were retrospectively compared. Results: The study included 181 patients (96 males, 85 females), with an average age of 55.5 years (age range, 29∼78 years). Sixty-eight patients had lesions in the upper esophagus, 60 patients had lesions in the middle esophagus and 53 patients had lesions in the lower esophagus. Secondary layers of esophageal lesions were predominant (91/181) in the cases. Pathological findings were available for 34 patients. Compared with the pathological findings, the diagnostic accuracy of EUS was 91.1%. Conclusions: Probe EUS by using the jelly-filled method is convenient and safe to perform and provides clear and full-circumferential imaging of a lesion. It is an alternative method to use in place of previously used probe-EUS procedures for the assessment of esophageal subepithelial lesions. (Korean J Gastrointest Endosc 2008;36:125-131)

3,148 View
22 Download

Endoscopic Ultrasonography in Upper Gastrointestinal Subepithelial Lesions: Tae Kyoung Won, M.D., Eun Young Kim, M.D., Chang Jin Seo, M.D., Byung Seok Kim, M.D., Young Sup Kim, M.D., Kyu Hyun Cho, M.D., Jin Tae Jung, M.D., Joong Goo Kwon, M.D., Chang Hyeong Lee, M.D. and Ho Gak Kim, M.D.; Korean J Gastrointest Endosc 2006;32(5):313-319. Published online May 30, 2006

Abstract PDF: Background
/Aims: Endoscopic ultrasonography (EUS) is known for its value to characterize incidentally found subepithelial lesions, and we so reviewed our data to validate the norm. Methods: We analyzed the records of the patients with suspected subepithelial lesions at the time of endoscopy, which was performed from Aug. 2001 to Oct. 2004. Results: The data includes 622 patients (248 males) with average age of 52 years (age range 15∼83 years). Extraluminal compression was noted in 10.1% of the patients. Intraluminal lesions were dominant in the stomach and their average size was 14.8 mm. The inner three wall layers were the predominant layers of origin. Mesenchymal tumors were the most frequent EUS impression. Pathologic findings were available for 88 patients and 80.7% of them were benign. Compared with the pathology, the diagnostic accuracy of EUS was 78.4%. The differentiation of malignant and benign GISTs by the EUS findings was 56.3%. Among the 60 EUS cases that had follow up data available (at mean interval of 12.2 months) and who also had less than 3 cm benign lesions, growth was detected only in 10 cases (17%). Pathology confirmed that the lesions in 3 of them were benign. Conclusions: More than 10% of the subepithelial lesions found from endoscopy were extraluminal compression. The majority of intramural lesions were benign. The EUS impression was relatively accurate and helpful for the management of upper gastrointestinal submucosal lesions. (Korean J Gastrointest Endosc 2006;32:313⁣319)

2,769 View
16 Download

First
Prev
Page of 1
Next
Last

Search