{
  "abstract": "Background and Aims: Submucosal tunneling endoscopic resection (STER) represents a minimally invasive therapeutic technique for selected gastric GI stromal tumors (GISTs). However, procedural success is highly dependent on lesion characteristics and technical execution. We present a structured approach to gastric GISTs and a key technical consideration for successful STER by contrasting an unsuccessful case and a successful case. Methods: Two patients with gastric GISTs arising from the muscularis propria underwent attempted STER. Preprocedural EUS was performed to assess lesion size, depth, and growth pattern. Procedural steps, including tunnel strategy, scope orientation, and adjunctive maneuvers, were analyzed to identify factors influencing technical success. Results: In the first case, STER was performed with a long tunnel; however, because of the exophytic nature of the GIST, it failed to be visualized, leading to procedural abortion. In contrast, the second case demonstrated successful STER using a short tunnel approach, a horizontal mucosal incision to facilitate specimen extraction, careful scope reorientation to establish a tangential dissection plane, and snare-assisted confirmation of complete tumor mobilization. A mucosal tear occurred secondary to forward pressure during dissection and was managed with endoscopic suturing without adverse events. Conclusions: Successful STER for gastric GISTs can result from meticulous preprocedural EUS assessment, horizontal incision with short tunnel creation, and selective use of adjunctive techniques. Awareness of these technical principles may improve procedural success and safety.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA; Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia",
    "Division of Gastroenterology, Hepatology and Nutrition, University of Utah, Salt Lake City, Utah, USA",
    "Division of Gastroenterology and Hepatology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA",
    "Department of Medicine, Boston Medical Center–Brighton, Boston, Massachusetts, USA",
    "Harvard Medical School, Boston, Massachusetts, USA",
    "Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA; Corresponding author: Hiroyuki Aihara, MD, PhD, Director of Tissue Resection Program, Gastroenterology, Hepatology, and Endoscopy Brigham and Women’s Hospital, 75 Francis St, Boston, Massachusetts 02115, USA."
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Abdulrahman Qatomah, MD"
    },
    {
      "affs": [
        1
      ],
      "name": "Daryl Ramai, MD, MSc, MPH"
    },
    {
      "affs": [
        2
      ],
      "name": "Talal Alenezi, MD"
    },
    {
      "affs": [
        3
      ],
      "name": "Dimo Dimitrov, MD"
    },
    {
      "affs": [
        4
      ],
      "name": "Mohammad Almesned, MD, MSc"
    },
    {
      "affs": [
        5
      ],
      "name": "Hiroyuki Aihara, MD, PhD"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fp3zef8cpv41b.bib",
  "cited_by": 0,
  "doi": "10.1016/j.vgie.2026.06.012",
  "fulltext_url": "http://www.sciencedirect.com/science/article/pii/S2468448126001797",
  "id": "fp3zef8cpv41b",
  "issns": [
    "2468-4481"
  ],
  "landing_url": "https://doi.org/10.1016/j.vgie.2026.06.012",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC799-869"
    ],
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      "openalex",
      "2715|Gastrointestinal Tumor Research and Treatment"
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  "pdf_url": "https://www.videogie.org/article/S2468-4481(26)00179-7/pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-08",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/fp3zef8cpv41b.ris",
  "sources": [
    {
      "first_seen": "2026-11-08T14:20:47Z",
      "native_id": "053c8b85d9154d7ca0924f26d1a6f509",
      "source": "doaj",
      "url": "https://doi.org/10.1016/j.vgie.2026.06.012"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2715|Gastrointestinal Tumor Research and Treatment",
      "subfield": "general"
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  "title": "Submucosal tunneling endoscopic resection of gastric gastrointestinal stromal tumors: technical tips for optimal outcomes",
  "title_text": "Submucosal tunneling endoscopic resection of gastric gastrointestinal stromal tumors: technical tips for optimal outcomes",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T14:20:47Z",
  "url": "https://research.draconitic.com/paper/fp3zef8cpv41b",
  "venue": "VideoGIE",
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}