Practice Guidelines for the Diagnosis and Treatment of Subepithelial Lesions 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 and potentially malignant tumors. Although most SELs are asymptomatic and found incidentally, accurate diagnosis remains challenging owing to their subepithelial location, necessitating advanced imaging and tissue acquisition techniques. Endoscopic ultrasonography plays a crucial role in differentiating SELs, although its diagnostic accuracy remains limited. The Korean College of Helicobacter and Upper Gastrointestinal Research has developed evidence-based practice guidelines for the diagnosis and endoscopic treatment of SELs to address the need for standardized clinical management. These guidelines were established through a systematic review of existing literature and expert consensus, resulting in 11 key recommendations for addressing diagnostic strategies, surveillance intervals, biopsy techniques, and indications for endoscopic or surgical resection.