Submucosal tunneling endoscopic resection for upper gastrointestinal multiple submucosal tumors originating from the muscular propria layer: A feasibility study.
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Date
2014-02
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Abstract
BACKGROUND AND AIMS: In recent years, submucosal tunneling endoscopic resection (STER) was applied more and more often for single
gastrointestinal (GI) submucosal tumor (SMT). However, little is known about this technique for treating multiple SMTs in GI tract. In the present
study, we investigated the feasibility and outcome of STER for upper GI multiple SMTs originating from the muscularis propria (MP) layer.
PATIENTS AND METHODS: A feasibility study was carried out including a consecutive cohort of 23 patients with multiple SMTs from MP layer in
esophagus, cardia, and upper corpus who were treated by STER from June 2011 to June 2014. Clinicopathological, demographic, and endoscopic
data were collected and analyzed. RESULTS: All of the 49 SMTs were resected completely by STER technique. Furthermore, only one tunnel was
built for multiple SMTs of each patient in this study. En bloc resection was achieved in all 49 tumors. The median size of all the resected tumors
was 1.5 cm (range 0.8–3.5 cm). The pathological results showed that all the tumors were leiomyoma, and the margins of the resected specimens
were negative. The median procedure time was 40 min (range: 20–75 min). Gas‑related complications were of the main complications, the rates
of subcutaneous emphysema and pneumomediastinum, pneumothorax, and pneumoperitoneum were 13.0%, 8.7% and 4.3%. Another common
complication was thoracic effusion that occurred in 2 cases (8.7%), among which only 1 case (4.3%) with low‑grade fever got the drainage. Delayed
bleeding, esophageal fistula or hematocele, and infection in tunnel were not detected after the operation there were no treatment‑related deaths.
The median hospital stay was 4 days (range, 2–9 days). No residual or recurrent lesion was found during the follow‑up period (median 18, ranging
3–36 months). CONCLUSION: Submucosal tunneling endoscopic resection is a safe and efficient technique for treating multiple esophageal SMTs
originating from MP layer, which can avoid patients suffering repeated resections.
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Keywords
Multiple, submucosal tumor, submucosal tunneling endoscopic resection
Citation
Zhang C*, Hu JW*, Chen T, Zhou PH, Zhong YS, Zhang YQ, Chen WF, Li QL, Yao LQ, Xu MD. Submucosal tunneling endoscopic resection for upper gastrointestinal multiple submucosal tumors originating from the muscular propria layer: A feasibility study. Indian Journal of Cancer. 2014 Feb; 51(6_Suppl): s52-55.