Background and Purpose Esophageal submucosal tumors (SMTs) are primarily benign but can have the potential for malignancy. Surgery is the primary treatment; however, the development of endoscopic techniques has promoted the use of endoscopic resection for esophageal SMTs.Submucosal tunneling endoscopic resection (STER) is the current optimal treatment for esophageal SMTs; however, it is challenging to perform in cases of tumors located in the upper esophagus and cardia as well as those with a diameter > 3.5 cm. Based on STER, we proposed and used open STER (O-STER) for special esophageal SMTs. The study aimed to evaluate the safety and efficacy of O-STER for special esophageal SMTs, including those located in the upper esophagus and cardia and those with a diameter > 3.5 cm.
MethodsThe study enrolled 21 patients whose baseline characteristics, clinical data, and follow-up results were retrospectively analyzed.Results A total of 21 lesions were resected. The mean patient age was 44.2 ± 14.4 years. The mean tumor size was 38.2 ± 12.2 mm; 16 (76.2%) tumors had a diameter ≥ 3.5 cm. Tumors were in the cardia in 14 (66.7%) cases and in the upper esophagus in 2 (9.5%) cases. The mean operation time was 56.7 ± 19.3 minutes. The en bloc and complete resection rates were both 100%. There was 1 (4.8%) case of subcutaneous emphysema; no other serious complications were noted. Pathological examinations suggested that most tumors were leiomyomas and had negative margins. During the mean follow-up period of 26.7 months, no cases of residue, recurrence, or metastasis were observed.Conclusions O-STER is a safe and effective treatment for special esophageal SMTs that can reduce operative difficulty and complication rate.