Impact of Size on Endoluminal Approaches to Submucosal Tumors of the Stomach

Gastric subepithelial lesions (SELs) represent a heterogenous group of mass lesions that arise from the gastric mucosa. Several endoscopic techniques can be used to manage gastric SELs once the decision is made to pursue resection, including endoscopic submucosal resection, endoscopic submucosal dissection, submucosal tunnel endoscopic resection, and endoscopic full-thickness resection. In addition to other clinical and anatomic factors, lesion size has important implications on the ability to obtain a complete resection while minimizing risk of adverse events. This article reviews technical considerations and available data regarding how size may impact the endoscopic approach to gastric SEL resection.