%0 Journal Article
%T The smart approach to surgical treatment of submucosal tumors  based on preoperative EUS-typing
%A Dzhantukhanova, Seda
%A Starkov, Yury
%A Solodinina, Elena
%A Zamolodchikov, Rodion
%J Annals of Laparoscopic and Endoscopic Surgery
%D 2019
%B 2019
%9 
%! The smart approach to surgical treatment of submucosal tumors  based on preoperative EUS-typing
%K 
%X 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
%U https://ales.amegroups.org/article/view/5366
%V 4
%P 
%@ 2518-6973