Submucosal tunneling endoscopic resection for leiomyomas located on opposite esophageal walls: the role of a tortuous submucosal tunnel

Zhou, Fuxi; Tan, Yuyong; Chu, Yi; Hu, Chin-Hwa; Huo, Jirong; Liu, Deliang

doi:10.1055/s-0042-111323

Cited by 8 publications

(5 citation statements)

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“…Only a few cases have been reported concerning STER for multiple GI-SMTs, and the maximal number of SMTs reported in a patient has been 3. [10,11,21,22] In the present study, 30 SMTs were found in 12 patients (the maximal number of SMTs was 7 in a patient), [23] and all of them were successfully removed by the STER technique within 1 tunnel. No obvious complication or recurrence was noticed, suggesting that 1-tunnel STER is feasible and effective for treating multiple upper GI-SMTs.…”

Section: Discussionmentioning

confidence: 58%

Submucosal 1-tunnel endoscopic resection for treating upper gastrointestinal multiple submucosal tumor originating from the muscularis propria layer

Wang¹,

Tan

Huo

et al. 2019

Medicine

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To explore the feasibility and efficacy of submucosal 1-tunnel endoscopic resection (1-tunnel STER) for the treatment of multiple upper gastrointestinal submucosal tumors (GI-SMTs) originating from the muscularis propria (MP) layer. A total of 12 patients with multiple upper GI-SMTs (no less than 2 SMTs) who underwent 1-tunnel STER from April 2013 to October 2017 were included. Clinical data on general characteristics, operation-related parameters, adverse events, and follow-up results were recorded and analyzed. All 12 patients underwent 1-tunnel STER successfully, and the mean operation time was 92.1 ± 40.8 minutes. A total of 30 SMTs were resected, out of which 27 were in the esophagus and 3 were in the stomach. The mean diameter was 15.0 ± 8.2 mm (range, 3–38 mm). All the SMTs were resected en bloc uneventfully. The SMTs comprised 28 leiomyomas and 2 gastric stromal tumors (low risk). No recurrence was noticed during a mean follow-up of 24.9 ± 15.3 months (range, 1–52 months). One-tunnel STER may serve as a feasible and effective technique for the treatment of multiple upper GI-SMTs originating from the MP layer. A large-scale prospective study is warranted for a confirmative conclusion.

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Section: Discussionmentioning

confidence: 58%

Submucosal 1-tunnel endoscopic resection for treating upper gastrointestinal multiple submucosal tumor originating from the muscularis propria layer

Wang¹,

Tan

Huo

et al. 2019

Medicine

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“…In 2016, our team reconfirmed the safety of the procedure, demonstrating a perioperative complication rate of 8.3% and an en bloc resection rate of 90.6% in an analysis of 180 patients with tumors with a larger diameter of 2 to 5 cm 7 . However, limited studies have analyzed subgroup of patients with multiple SMTs 12–14 . In 2016, Zhou et al reported on the use of STER for multiple leiomyomas located in opposite esophageal walls by a tortuous submucosal tunnel 13 .…”

Section: Disscussionmentioning

confidence: 86%

“…In the present study, all the 120 SMTs were confirmed as leiomyoma by pathological evaluation with no GI stromal tumor found. In addition, the postoperative pathology of previous reports of multiple SMTs was leiomyoma 12–14 . However, previous studies not of multiple SMTs demonstrated a much higher rate of GI stromal tumor (15.6% to 34%) 7,8,16 .…”

Section: Disscussionmentioning

confidence: 92%

“…However, limited studies have analyzed subgroup of patients with multiple SMTs 12–14 . In 2016, Zhou et al reported on the use of STER for multiple leiomyomas located in opposite esophageal walls by a tortuous submucosal tunnel 13 . Another study reported on the use of STER for simultaneous esophageal and cardia SMTs originating from the MP layer 14 .…”

Section: Disscussionmentioning

confidence: 99%

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Submucosal tunneling endoscopic resection treatment of multiple gastrointestinal submucosal tumors

Liu

Wang

Liu

et al. 2021

J of Gastro and Hepatol

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Background and Aim Gastrointestinal submucosal tumors (SMTs) can be removed by submucosal tunneling endoscopic resection (STER). However, limited studies have evaluated STER for the removal of multiple upper gastrointestinal SMTs. The aim of this study was to evaluate the feasibility and outcomes of STER in the treatment of multiple upper gastrointestinal SMTs. Methods From January 2011 to April 2020, the cases of patients with multiple upper gastrointestinal SMTs undergoing STER were retrospectively analyzed. Variables of clinicopathological characteristics, major adverse events (mAEs), and follow up were collected and analyzed. Results Submucosal tunneling endoscopic resection was performed in 54 patients (48 male and 6 female patients) with 120 SMTs. Forty‐four patients had two tumors, eight patients had three tumors, and two patients had four tumors. The median size of each patient was 1.8 cm (range 0.7 to 3.5 cm). Forty‐five patients had tumors removed by one tunnel, and nine patients by two tunnels. The median procedure time was 50 min (range 14 to 120 min), and the mAE rate was 16.7% (9/54). No significant differences were found between patients with two tumors and those with > 2 tumors in terms of tunnel length, hospital stay, procedure time, and mAEs (all P > 0.05). In addition, patients with two tunnels had procedure time, hospital stay, and mAE rates comparable with those with one tunnel (all P > 0.05). No local recurrence or distant metastasis occurred during a median follow up of 64 months. Conclusions Submucosal tunneling endoscopic resection is a safe and effective technique for the resection of multiple upper gastrointestinal SMTs.

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“…При множественных лейомиомах в литературе [14,15] описано одномоментное удаление нескольких образований при помощи тоннельных резекций: случай удаления двух лейомиом, находящихся на противоположных стенках пищевода, с использованием одного извитого подслизистого туннеля вместо двух прямых, что позволило уменьшить время операции, риск осложнений и объем подслизистой диссекции.…”

Section: кеуWords: Esophagus Submucosal Tumor Leiomyoma Submucosalunclassified

The experience of endoscopic resection of benign tumors of the esophagus

Смирнов¹,

Бураков²,

Blinov³

et al. 2018

VESTNIK KHIRURGII IMENI I.I.GREKOVA

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The objectiveof the study is to evaluate the safety and efficacy of the using of minimally invasive endoscopic methods in the treatment of submucosal esophageal tumors.Material and methods.The study included 89 patients with benign tumors of the esophagus. Endoscopic ultrasonography (EUS) was performed to determine the esophageal wall layer from which the tumor grows the size of the tumor and its relationship with the surrounding organs.Results.Submucosal tunneling resection was performed successfully in 73 patients. The average operation time was 84.5 minutes. In 16 patients, the tumor was removed by submucosal endoscopic dissection (SED). The average duration of ESD was 39.4 minutes. Among this group of patients we faced nonstandard cases of practical interest: leiomyomas of the upper part of the esophagus, plexiform leiomyomas and multiple leiomyomas. Each of the above types had its own specificity in diagnosis, treatment and postoperative management of patients.Conclusion.Submucosal esophageal tumors vary in types of growth, sizes, number of tumors, localization and its relationship with the surrounding organs. Scrupulous diagnosis of each case is necessary which will allow choosing the most appropriate treatment tactics for the patient.

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Submucosal tunneling endoscopic resection for leiomyomas located on opposite esophageal walls: the role of a tortuous submucosal tunnel

Abstract: This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.would increase the complication rate. We successfully removed both of the tumors by STER within a single tunnel by creating a tortuous submucosal tunnel.

Cited by 8 publications

References 0 publications

Submucosal 1-tunnel endoscopic resection for treating upper gastrointestinal multiple submucosal tumor originating from the muscularis propria layer

Submucosal 1-tunnel endoscopic resection for treating upper gastrointestinal multiple submucosal tumor originating from the muscularis propria layer

Submucosal tunneling endoscopic resection treatment of multiple gastrointestinal submucosal tumors

The experience of endoscopic resection of benign tumors of the esophagus

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