위 상피하 종양의 내시경적 치료

Abstract

Most of subepithelial tumor (SET) in stomach is incidentally found during esophagogastroduodenoscpic examination. Even small gastric SETs less than 2.0 cm might have malignant potential, thus ambiguous cases should be removed and pathologically confirmed for optimal diagnosis and treatment. As endoscopic techniques are developed, endoscopic removal of gastric SETs has been reported increasingly. The endoscopic procedures for resection of gastric SETs include classic methods such as snare polypectomy or incisional enucleation, and more progressive and standard technique such as endoscopic submucosal dissection. For gastric SETs originated from deeper layer including muscularis mucosa, novel procedures such as endoscopic submucosal tunnel dissection and endoscopic full-thickness resection (EFTR) are now being introduced, and cooperation with laparoscopic approach such as laparoscopy-assisted EFTR might be an alternative option to overcome shortcomings of endoscopic procedures only and ensure more safe and complete resection.