TY - JOUR AU - Dzhantukhanova, Seda AU - Starkov, Yury AU - Solodinina, Elena AU - Zamolodchikov, Rodion PY - 2019 TI - The smart approach to surgical treatment of submucosal tumors based on preoperative EUS-typing JF - Annals of Laparoscopic and Endoscopic Surgery; Vol 4 (August 2019): Annals of Laparoscopic and Endoscopic Surgery Y2 - 2019 KW - N2 - 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 UR - https://ales.amegroups.org/article/view/5366