Fig 1.
The non-submucosal injection endoscopic submucosal excavation (NSI-ESE) of a gastric SMT.
(A) An SMT was observed in corpus. (B) EUS shows that the lesion originates from the muscularis propria layer. (C) Without submucosal injection, the mucosa is directly incised circumferentially around the lesion. (D-E) Dissection is performed along the base of the lesion and En bloc resection was achieved. (F) The mucosal defect was closed with hemostatic clips.
Fig 2.
The procedure of mucosal snare resection endoscopic submucosal excavation (MSR-ESE).
(A) An SMT is observed. (B) The tumor originates from the muscularis propria layer on EUS. (C) Without submucosal lifting, The superficial mucosa over the lesion was partly resected with a snare. (D) The margins were extended and the tumor fully exposed using a Dual Knife. (E-F) En bloc resection of the lesion was achieved, and the wound was closed with hemostatic clips.
Table 1.
Baseline table.
Table 2.
Surgical Outcome.
Table 3.
Liner regression.
Table 4.
Adverse events.
Fig 3.
Limitations of snare-assisted ESE.
(A) The snare fails to grasp the tumor base when the lesion is large or non-protruding. (B) Only partial mucosal removal is achieved. (C) An ESD knife is needed to fully expose the tumor margins.