Endoscopic Resection of Submucosal Tumor of the Esophagus: Results in 62 Patients

Abstract

This method of endoscopic removal of submucosal tumors of the esophagus appears to be safe and effective in experienced hands. It allows complete histopathological workup, and at the same time complete removal of the tumor. The method can be considered as an alternative to surgery in symptomatic cases.

Endoscopic resection of gastrointestinal submucosal tumors assisted by endoscopic ultrasonography

“…Bleeding occurred in 9% of the patients in the series of Kojima et al [13], in 4.8% in the series of Hyun et al [10]; and in 16% and 13% in the series of Wei et al [20] and Hunt et al [9], respectively. All cases of bleeding were successfully managed by endoscopy.…”

“…No important complications were reported, and the ulcer was shown to be cured in 2-4 weeks. Hyun et al [10] reported the resection of 62 tumors, all of them located in the esophagus. Resection was complete in 98% of the cases.…”

“…This diagnosis will be based on criteria such as the tumor size, tumor cellularity, number of mitoses, growth pattern, presence of cohesion fibers, or nuclear pleomorphism. It is generally agreed that surgical or endoscopic removal of the submucosal lesion is the method of choice to achieve definitive diagnosis when the nature of the lesion is not precisely known [9,10,12,13,19,20]. On the other hand, echoendoscopy is the most suitable technique to apply before making the decision on whether the lesion should be removed and, if removal is the option of choice, to choose the safest approach for removal [4,16].…”

Indications of endoscopic submucosal dissection for symptomatic benign gastrointestinal subepithelial or carcinoid tumors originating in the submucosa

“…Endoscopic submucosal resection (ESMR) has been reported to be effective for the treatment of SETs (12)(13)(14)(15) and it is usually reserved for lesions that are confined to the submucosal or mucosal layers, due to the increased risk of perforation associated with ESMR of lesions originating in the MP layer. However, ESMR occasionally requires a large en-bloc resection and secure hemostasis may prove challenging.…”

A safe and efficient strategy for endoscopic resection of large, gastrointestinal lipoma

“…Numerous reports have suggested that endoscopic treatment of GI submucosal tumors is a valid alternative to invasion surgery [9][10][11][12]. However, the choice of treatment for GI lipomas is still controversial, because it has been documented that removal of lipomas 2 cm or greater in diameter (large lipoma) is associated with a greater risk of hemorrhage and perforation [13][14][15][16].…”