Practice Guidelines for the Diagnosis and Treatment of Subepithelial Lesion Observed in Upper Gastrointestinal Endoscopy

Abstract

Subepithelial lesions (SELs) of the upper gastrointestinal tract are commonly detected during endoscopic examinations and encompass a broad spectrum of benign, potentially malignant, and malignant tumors. While most SELs are asymptomatic and incidentally found, accurate diagnosis remains challenging due to their subepithelial location, necessitating advanced imaging and tissue acquisition techniques. Endoscopic ultrasound (EUS) plays a crucial role in differentiating SELs, but its diagnostic accuracy remains limited. In response to the need for standardized clinical management, the Korean College of Helicobacter and Upper Gastrointestinal Research has developed evidence-based practice guidelines for the diagnosis and endoscopic treatment of SELs. These guidelines were established through a systematic review of existing literature and expert consensus, resulting in 11 key recommendations addressing diagnostic strategies, surveillance intervals, biopsy techniques, and indications for endoscopic or surgical resection.