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The smart approach to surgical treatment of submucosal tumors based on preoperative EUS-typing

	author = {Seda Dzhantukhanova and Yury Starkov and Elena Solodinina and Rodion Zamolodchikov},
	title = {The smart approach to surgical treatment of submucosal tumors  based on preoperative EUS-typing},
	journal = {Annals of Laparoscopic and Endoscopic Surgery},
	volume = {4},
	number = {0},
	year = {2019},
	keywords = {},
	abstract = {Background: Non-epithelial tumors of the gastrointestinal tract are in general slowly progressing tumors for which lymphogenous metastasis are not typical. The preferred techniques for removal of non-epithelial tumors are minimally invasive surgical procedures with intraluminal, laparo- and thoracoscopic approaches. 
Methods: From 2005 to 2017, 168 patients with non-epithelial tumors of the esophagus, stomach, and duodenum were examined, and 80 patients with non-epithelial tumors were operated at the A.V. Vishnevsky Institute of Surgery. The key method to examine patients was an endoscopic ultrasound (EUS) to determine the putative non-epithelial tumor type, as well as the source wall layer and the size of the tumor base. Laparoscopic atypical stomach resections were performed in 62 cases with laparoscopic ultrasound and/or endoscopic navigation. In 7 cases, endoscopic tunnel dissections with and without laparoscopic assistance were performed, in 11, removal of the tumor with the mucosal covering after submucosal dissection. 
Results: Based on an analysis of the data from preoperative endosonography, intraoperative ultrasound and histological examination of the resected specimen, a working classification of non-epithelial tumors was developed that determines what type of surgical intervention will be the most effective with maximum organ preservation.
Conclusions: This classification guides the surgeon to the most effective, organ-sparing and safe intervention according to preoperative sonographic findings},
	url = {}