A comparison of submucosal tunneling endoscopic resection and endoscopic full-thickness resection for gastric fundus submucosal tumors

Duan, Tianying; Tan, Yuyong; Wang, Xuehong; Lv, Liang; Liu, Deliang

doi:10.17235/reed.2017.4699/2016

Cited by 14 publications

(4 citation statements)

References 30 publications

(38 reference statements)

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“…However, surgical resection, regardless of whether open surgery or video-assisted thoracoscopic surgery (VATS) is performed, seems to be more invasive than endoscopic resection[35-38]. STER is regarded as the optimum method for resecting SMTs originating from the MP layer based on its advantages of a high en bloc resection rate and the ability to maintain the integrity of the mucosa[29,39-41]. The creation of a tunnel not only maintains the integrity of the mucosa, but also decreases the likelihood of perforation, postoperative infection, fistula, and stricture[12].…”

Section: Discussionmentioning

confidence: 99%

Submucosal tunneling endoscopic resection: An effective and safe therapy for upper gastrointestinal submucosal tumors originating from the muscularis propria layer

Du¹,

Chai²,

Linghu³

et al. 2019

WJG

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AIMTo evaluate the effectiveness and safety of submucosal tunneling endoscopic resection (STER) and compare its outcomes in esophageal and cardial submucosal tumors (SMTs) of the muscularis propria (MP) layer.METHODSFrom May 2012 to November 2017, 173 consecutive patients with upper gastrointestinal (GI) SMTs of the MP layer underwent STER. Overall, 165 patients were included, and 8 were excluded. The baseline characteristics of the patients and SMTs were recorded. The en bloc resection rate, complete resection rate, residual rate, and recurrence rate were calculated to evaluate the effectiveness of STER, and the complication rate was recorded to evaluate its safety. Effectiveness and safety outcomes were compared between esophageal and cardial SMTs.RESULTSOne hundred and twelve men and 53 women with a mean age of 46.9 ± 10.8 years were included. The mean tumor size was 22.6 ± 13.6 mm. Eleven SMTs were located in the upper esophagus (6.7%), 49 in the middle esophagus (29.7%), 46 in the lower esophagus (27.9%), and 59 in the cardia (35.7%). Irregular lesions accounted for 48.5% of all lesions. STER achieved an en bloc resection rate of 78.7% (128/165) for GI SMTs with an overall complication rate of 21.2% (35/165). All complications resolved without intervention or were treated conservatively without the need for surgery. The en bloc resection rates of esophageal and cardial SMTs were 81.1% (86/106) and 72.1% (42/59), respectively (P = 0.142), and the complication rates were 19.8% (21/106) and 23.7% (14/59), respectively, (P = 0.555). The most common complications for esophageal SMTs were gas-related complications and fever, while mucosal injury was the most common for cardial SMTs.CONCLUSIONSTER is an effective and safe therapy for GI SMTs of the MP layer. Its effectiveness and safety are comparable between SMTs of the esophagus and cardia.

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Section: Discussionmentioning

confidence: 99%

Submucosal tunneling endoscopic resection: An effective and safe therapy for upper gastrointestinal submucosal tumors originating from the muscularis propria layer

Du¹,

Chai²,

Linghu³

et al. 2019

WJG

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“…When compared with endoscopic mucosal resection and ESD, STER has been associated with a lower rate of complications 82. Last, when STER has been compared with endoscopic full-thickness resection, another minimally invasive means of SMT resection, studies have shown that the clinical outcomes are again relatively similar, but that STER was associated with decreased suture time, smaller number of clips used to close the incisions,86 and shorter hospital stay 87…”

Section: Submucosal Tunneling Endoscopic Resection (Ster)mentioning

confidence: 99%

New Applications for Submucosal Tunneling in Third Space Endoscopy

Karanfilian

Kahaleh

2022

Journal of Clinical Gastroenterology

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Third space endoscopy (TSE), a type of natural orifice transluminal endoscopic surgery, was first introduced a decade ago, and since then, has revolutionized the field of therapeutic endoscopy. TSE involves tunneling into the submucosal space between the intestinal mucosa and the muscularis propria. By accessing this “third space,” endoscopists can perform minimally invasive myotomies, resections, and dissections while maintaining the mucosa and preventing full-thickness perforation. TSE procedures can be used to treat motility disorders as well as neoplasms throughout the gastrointestinal tract, which were traditionally conditions that would require open or laparoscopic surgery. The main TSE procedures include peroral endoscopic myotomy, gastric peroral endoscopic myotomy, Zenker peroral endoscopic myotomy, submucosal tunneling for endoscopic resection, endoscopic submucosal tunnel dissection, peroral endoscopic tunneling for restoration of the esophagus, and per-rectal endoscopic myotomy. Some of those procedures have now been accepted as viable alternative to surgical techniques due to their limited invasiveness, safety and cost. This review will explore the different techniques recently added to our arsenal while describing their potential efficacy and limitations.

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“…This clinical condition that once required laparotomy and open common bile duct exploration has been routinely treated in recent years using laparoscopic access to the remaining stomach with transabdominal ERCP. It is now becoming more common to use LAMS to provide a pathway through the remaining stomach from the digestive tract so that more conventional ERCP can be offered to the patient without the need for surgery (12,13). LAMS is also used as an effective and more durable alternative to cholecystostomy placement in cases of acute cholecystitis in those who are too weak to undergo cholecystectomy (14,15).…”

Section: The Future Of Surgery and Endoscopymentioning

confidence: 99%

Endoscopy in surgery

et al. 2021

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In the last 20 years, there have been important developments in endoscopy. Initially, endoscopy was developed and used as a diagnostic tool. As new technology developed, these devices also became the basis for therapeutic maneuvers. In recent years, flexible endoscopes have been used to per- form procedures replacing traditional surgical approaches. Examples of this field are transanal minimally invasive surgery, natural orifice transluminal endoscopic surgery, endoscopic metabolic surgery and third space endoscopies. Throughout history, surgeons have played a vital role in the design and development of endoscopic techniques, procedures, and equipment. Surgeons continue to lead the advancement of endoscopy, make important contributions, and serve as role models for innovation.

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A comparison of submucosal tunneling endoscopic resection and endoscopic full-thickness resection for gastric fundus submucosal tumors

Cited by 14 publications

References 30 publications

Submucosal tunneling endoscopic resection: An effective and safe therapy for upper gastrointestinal submucosal tumors originating from the muscularis propria layer

Submucosal tunneling endoscopic resection: An effective and safe therapy for upper gastrointestinal submucosal tumors originating from the muscularis propria layer

New Applications for Submucosal Tunneling in Third Space Endoscopy

Endoscopy in surgery

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