Submucosal tunneling endoscopic resection of upper gastrointestinal tract tumors arising from muscularis propria

Jain, Deepanshu

doi:10.20524/aog.2017.0128

Cited by 22 publications

(19 citation statements)

References 25 publications

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“…Subsequently, our center reported about the use of STER to treat esophageal and cardiac SMTs [16]. An increasing number of researchers from China and across the world have successively explored the STER technique [17–20]. The safety and efficacy of STER for treating esophageal SMTs have been verified by a large number of clinical studies [21, 22].…”

Section: Discussionmentioning

confidence: 99%

“…Domestic experts have reached consensus on endoscopic diagnosis management of gastrointestinal SMT [23]. Then, combining the literature review with our own experience [24–26], we believe that patients who underwent STER should meet the following conditions: (1) the tumor being <4 cm, (2) the tumor originating from the MP layer and protruding into the lumen, and (3) the tumor being confirmed to be benign or excluding the possibility of malignancy. Before the operation, we required all the patients to receive a clinical evaluation.…”

Section: Discussionmentioning

confidence: 99%

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Submucosal Tunnel Endoscopic Resection for Esophageal Submucosal Tumors: A Multicenter Study

Huang

et al. 2018

Gastroenterology Research and Practice

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Background Submucosal tumors (SMTs) are primarily benign tumors, but some may have a malignant potential. Endoscopic submucosal dissection that has been used for removing esophageal SMTs could cause perforation. Submucosal tunnel endoscopic resection (STER) is an improved and an effective technique for treating esophageal SMTs. Aims This study was conducted to evaluate the efficacy and safety of STER for treating esophageal SMTs. Methods A retrospective study design was adopted to analyze the baseline characteristics, clinical outcomes, and follow-up data of patients with esophageal SMTs, which originated from the muscularis propria layer and were treated with STER from September 2011 to May 2018. Results A total of 119 lesions were included from 115 patients who were successfully treated with STER. The mean age of the patients was 49.7 ± 10.7 years. The lesions were primarily located in the middle and lower esophagus. The mean size of the lesions was 19.4 ± 10.0 mm. The mean operation duration was 46.7 ± 25.6 min, and the mean duration of hospitalization was 5.9 ± 2.8 days. The total en bloc resection rate and the complete resection rate were 97.5% and 100%, respectively. Regarding complications, there were 9 (7.8%) cases of perforation, 2 (1.7%) cases of pneumothorax, and 9 (7.8%) cases of subcutaneous emphysema. Histopathological results revealed 113 (95.0%) cases of leiomyoma, 5 (4.2%) cases of gastrointestinal stromal tumors, and 1 (0.8%) case of a granular cell tumor. During the mean 15-month follow-up, there were no cases of recurrence and distant metastasis. Conclusions STER is a safe and feasible technique for treating esophageal SMTs originating from the muscularis propria layer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Submucosal Tunnel Endoscopic Resection for Esophageal Submucosal Tumors: A Multicenter Study

Huang

et al. 2018

Gastroenterology Research and Practice

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“…The incidence of STER-related complications is 0-66.7%, and gas-related complications are the most common complications, with an incidence of 0 to 66.7%[137,141,142]. The incidence of STER-related complications mostly ranges from 5% to 25%[123,124,126,127,129,139,143-148]. The oesophagus is the safest area for performing STER, with a low incidence of complications, namely, 9.5% to 16.7%[129,145].…”

Section: Dett For Mp Lesions: Stermentioning

confidence: 99%

Consensus on the digestive endoscopic tunnel technique

Chai

Linghu

et al. 2019

WJG

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With the digestive endoscopic tunnel technique (DETT), many diseases that previously would have been treated by surgery are now endoscopically curable by establishing a submucosal tunnel between the mucosa and muscularis propria (MP). Through the tunnel, endoscopic diagnosis or treatment is performed for lesions in the mucosa, in the MP, and even outside the gastrointestinal (GI) tract. At present, the tunnel technique application range covers the following: (1) Treatment of lesions originating from the mucosal layer, e.g ., endoscopic submucosal tunnel dissection for oesophageal large or circular early-stage cancer or precancerosis; (2) treatment of lesions from the MP layer, per-oral endoscopic myotomy, submucosal tunnelling endoscopic resection, etc .; and (3) diagnosis and treatment of lesions outside the GI tract, such as resection of lymph nodes and benign tumour excision in the mediastinum or abdominal cavity. With the increasing number of DETTs performed worldwide, endoscopic tunnel therapeutics, which is based on DETT, has been gradually developed and optimized. However, there is not yet an expert consensus on DETT to regulate its indications, contraindications, surgical procedure, and postoperative treatment. The International DETT Alliance signed up this consensus to standardize the procedures of DETT. In this consensus, we describe the definition, mechanism, and significance of DETT, prevention of infection and concepts of DETT-associated complications, methods to establish a submucosal tunnel, and application of DETT for lesions in the mucosa, in the MP and outside the GI tract (indications and contraindications, procedures, pre- and postoperative treatments, effectiveness, complications and treatments, and a comparison between DETT and other operations).

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“…There was no local recurrence or distant metastasis noted in any of the studies; followup ranged from 1 to 36 months. 68 STER was initially performed in the esophagus and cardia with lesions no >35 mm in diameter. Inoue et al noted that two tumors of 60 and 75 mm were too large to be removed through the submucosal tunnel, but the rest of the tumors between 1.2 and 3 cm were safely removed with little complications and no recurrence.…”

Section: Stermentioning

confidence: 99%

Endoscopic Intramural Surgery Part 1: Resectional Therapies

2018

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Endoscopic resectional therapies for lesions of gastrointestinal tract have progressed rapidly over the past two decades. Advances in minimally invasive endoscopic approaches continue to emerge and evolve, while boundaries of resection techniques continue to be pushed. The concept of third space endoscopy with mucosal flap as a safety valve has emerged arguably as the most innovative technique among these approaches. We review several techniques for intramural endoscopic resection of lesions of the gastrointestinal tract, but to gain a full understanding of why these exist, we must first examine the background from which they emerged.

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Submucosal tunneling endoscopic resection of upper gastrointestinal tract tumors arising from muscularis propria

Cited by 22 publications

References 25 publications

Submucosal Tunnel Endoscopic Resection for Esophageal Submucosal Tumors: A Multicenter Study

Submucosal Tunnel Endoscopic Resection for Esophageal Submucosal Tumors: A Multicenter Study

Consensus on the digestive endoscopic tunnel technique

Endoscopic Intramural Surgery Part 1: Resectional Therapies

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