A139 SUBMUCOSAL TUNNELING ENDOSCOPIC RESECTION (STER) FOR ESOPHAGEAL GIST: A CASE REPORT
Bibliographic record
Abstract
Abstract Background Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors found throughout the gastrointestinal tract, with esophageal GISTs being particularly uncommon. Surgical resection is the standard treatment option, though it is associated with significant morbidity. Submucosal Tunneling Endoscopic Resection (STER) is a minimally invasive technique for per-oral subepithelial tumor removal with preservation of the surrounding esophagus and no need for thoracoscopy or mediastinoscopy. Herein, we report a successful case of STER for esophageal GIST in an elderly Canadian patient. Aims To present the successful management of an esophageal GIST using submucosal tunneling endoscopic resection. Methods Case report and literature review. Results: Case Report An 80-year-old man with dysphagia underwent an EUS for a 1.5 cm subepithelial lesion identified in his mid-esophagus on EGD. EUS showed a hypoechoic lesion arising from the muscularis propria. Biopsy confirmed a spindle cell tumor, C-KIT positive consistent with GIST. The patient was offered transthoracic surgical resection but declined given the associated risks and complications. An interval CT scan demonstrated a 4 mm increase in the size of the tumor. The patient was referred for consideration of endoscopic resection. He ultimately underwent submucosal tunneled endoscopic resection of the GIST with no complications. The procedure was performed by creating a mucosal flap over the GIST via submucosal tunnelling with subsequent traction assisted full thickness myotomy surrounding the lesion while preserving the capsule, followed by clip closure of the mucosotomy. Pathology confirmed R0 resection with low mitotic rate. A routine esophagram post-procedure showed no contrast leakage, and the patient was discharged the following day. Literature Review STER is a minimally invasive technique for resection of gastrointestinal subepithelial lesions first reported in 2012. It offers several advantages including preservation of GI tract function, rapid recovery time, and low adverse event rate but requires careful lesion selection and technical facility with endoscopic submucosal dissection, myotomy and defect closure. Studies have demonstrated high rates of complete resection with low complication risks, particularly in treating small to medium-sized tumors. To our knowledge, this case represents the first reported use of STER in Canada. Conclusions: Conclusions STER is a minimally invasive option for resection of subepithelial lesions. In this case it was used effectively with readily available equipment in a Canadian hospital. It reduces recovery time, preserves esophageal structure, and minimizes complications. Funding Agencies None
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.006 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".