This update is significant for gastroenterologists and other healthcare professionals involved in the treatment of GI tract lesions, providing them with the latest insights and techniques for managing these conditions.
Key Points:
- Subepithelial lesions, which arise from the wall of the GI tract, are typically small and often found incidentally during endoscopy or cross-sectional imaging. While most of these lesions are benign, about 15% have the potential for malignant transformation.
- Endoscopic full-thickness resection has become a novel treatment option for select subepithelial lesions. This procedure can be performed using either an “exposed” or a “nonexposed” technique.
- The “exposed” technique involves resecting all layers of the wall, including the mucosa. In contrast, the “nonexposed” approach preserves an overlying flap of mucosa, as seen in the submucosal tunneling endoscopic resection technique, or employs a “close first, then cut” method to prevent impending perforation.
Clinical Implications:
- The guidance aims to help clinicians select the most appropriate technique for each patient’s individual case, considering the nature of the subepithelial lesion and the specific circumstances of the patient.
- Understanding the differences between the “exposed” and “nonexposed” techniques is crucial for effective and safe endoscopic resection of these lesions.