Gut Liver.  2017 Sep;11(5):620-627. 10.5009/gnl15424.

Endoscopic Submucosal Tunnel Dissection for Upper Gastrointestinal Submucosal Tumors Originating from the Muscularis Propria Layer: A Single-Center Study

• Tang X
• Ren Y
• Huang S
• Gao Q
• Zhou J
• Wei Z
• Jiang B
• Gong W

• KMID: 2389349
• DOI: http://doi.org/10.5009/gnl15424

Abstract

BACKGROUND/AIMS
In recent years, endoscopic submucosal tunnel dissection (ESTD) has gained popularity worldwide. The aim of this study was to evaluate the safety and efficacy of ESTD in treating upper gastrointestinal submucosal tumors (SMTs) in a large-volume endoscopic center.
METHODS
Patients with SMTs were enrolled in this study between January 2012 and January 2015. Demographic data, clinical data, and treatment outcome were collected and analyzed.
RESULTS
Seventy SMTs originating from the muscularis propria (MP) layer were identified in 69 patients. All patients successfully underwent the ESTD procedure. The mean procedure time was 49.0±29.5 minutes, and the mean tumor size was 18.7±7.2 mm. Among all lesions, the majority (70.0%) were located in the esophagus, 12.9% in the cardia, and 17.1% in the stomach. Complete resection was achieved in 67 lesions (95.7%). Perforation occurred in three patients (4.3%), who were treated by endoclips. Pneumothorax occurred in two patients (2.9%) and was successfully managed by thoracic drainage. During a median follow-up of 18.1 months, patients were free of local recurrence or distant metastasis.
CONCLUSIONS
Our results demonstrated the feasibility and safety of ESTD in treating upper gastrointestinal SMTs originating from the MP layer. Large-scale comparative studies with other treatment methods should be conducted in the future.

Keyword

Endoscopic submucosal tunnel dissection; Submucosal tumor; Upper gastrointestinal; Treatment outcome

MeSH Terms

Cardia
Drainage
Esophagus
Follow-Up Studies
Humans
Neoplasm Metastasis
Pneumothorax
Recurrence
Stomach
Treatment Outcome