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KMID : 1104820220100010016
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Journal of Digestive Cancer Research
2022 Volume.10 No. 1 p.16 ~ p.21
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Endoscopic Management of Gastric Subepithelial Tumor
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Lim Hyun-Chul
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Abstract
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Diagnosis of gastric subepithelial tumors (SETs) is sometimes difficult with conventional endoscopy or tissue sampling with standard biopsy, so non-invasive imaging modalities such as endoscopic ultrasound (EUS) and computed tomography are used to evaluate the characteristics of SETs features (size, location, originating layer, echogenicity, shape). However imaging modalities alone is not able to distinguish among all types of SETs, so histology is the gold standard for obtaining the final diagnosis. For tissue sampling, mucosal cutting biopsy and mucosal incision-assisted biopsy and EUS-guided fine-needle aspiration or biopsy (EUS-FNA or EUS-FNB) is commonly recommended. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are used for resection of SETs involving the mucosal and superficial submucosal layers, could not treat adequately and safely the SETs involving the deep mucosa and muscularis propria. Submucosal tunneling endoscopic resection (STER) and endoscopic full-thickness resection (EFTR) is used as a therapeutic option for the treatment of SETs with the development of reliable endoscopic closure techniques and tools.
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KEYWORD
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Gastric subepithelial tumors, Mucosal incision-assisted biopsy, EUS-guided fine-needle aspiration or biopsy, Submucosal tunneling endoscopic resection, Endoscopic full-thickness resection
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