Endoscopic resection of gastrointestinal submucosal lesions: a comparison between strip biopsy and aspiration lumpectomy

Gastrointest Endosc. 1996 Oct;44(4):404-10. doi: 10.1016/s0016-5107(96)70089-5.


Background: Endoscopic diagnosis and treatment of gastrointestinal submucosal lesions is still not established. We evaluated the clinical usefulness of two resection methods for submucosal lesions, using a "nonrandomized surgeon" design.

Methods: The strip biopsy method was evaluated at Tenri Hospital and the aspiration lumpectomy method was used at Kyoto University Hospital. The inclusion criteria for selecting patients were endosonographic findings indicating a tumor location within the submucosa.

Results: Seventy-seven patients were treated. The size of the specimens (mean +/- SEM) was 20.7 +/- 0.9 mm for the aspiration lumpectomy group and 14.0 +/- 0.8 mm for the strip biopsy group (p < 0.01). Aspiration lumpectomy was adequate for a definitive histologic diagnosis in 95% of the cases (36 of 38) as compared with 77% (30 to 39) of the cases treated by strip biopsy (p = 0.047). The eradication rate was 87% for the aspiration lumpectomy group, and 74% for the strip biopsy group (p = 0.274). The complication rate resulting from these procedures (hemorrhage, mean 5%) was acceptable. Repeated endoscopic examinations revealed no recurrence except for one lymphangioma.

Conclusions: Endoscopic resection, especially aspiration lumpectomy, provides a significant benefit for accurate final diagnosis and eradication of submucosal lesions.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Analysis of Variance
  • Biopsy / methods
  • Confidence Intervals
  • Diagnosis, Differential
  • Endosonography / instrumentation
  • Endosonography / methods*
  • Female
  • Gastric Mucosa / pathology*
  • Gastrointestinal Diseases / diagnosis*
  • Gastrointestinal Diseases / pathology
  • Gastrointestinal Diseases / therapy*
  • Humans
  • Intestinal Mucosa / pathology*
  • Male
  • Middle Aged
  • Sensitivity and Specificity
  • Treatment Outcome