Clinical Application Of Submucosal Tunneling Endoscopic Resection For Esophageal Tumors Originating From Muscularis Propria

Objective To discuss the efficacy and clinical application value of submucosal tunneling endoscopic resection for esophageal tumors originating from muscularis propriaMethods A total of 30 patients dignosed with esophageal tumors originating from muscularis propria comfirmed by gastroscope、 endoscopic ultrasonography and computerized tomography had accepted STER in retrospective study.The efficiecy、pathological diagnosis、postoperative therapeutic effect and complication was followed- up.Results All of 30 patients dignosed with esophageal tumors were completely resected through STER.The rate of complete resection of one time was 100%(30/30),the rate of en-bloc resection of one time was(93.3%,28/30).The size of tumors was about 0.4-6.0cm(2.2±1.6)cm, the operation time of tunnel mucosal incision to mucosal completely closure was ranging from 27 to 115 minutes,mean( 72.5±34.3) minutes. The length of tunnel was ranging from 4-8cm,mean(5.5±2.4)cm.Six to fifteen(mean10±3) hemostatic clips were used to close mucosal incision site.The mean amount of bleeding was15-30 ml without postoperative delayed hemorrhages.One patient developed subcutaneous emphysema(heal through the conservative treatment in four days, the rest did not appear gastrointestinal bleeding after operation、 mediastinitis or pleuritis.28 cases were by pathology proven to be leiomyoma, 1 case was confirmed to be granular cell tumor and 1 case to be gastrointestinal stromal tumors.No recurrence or residual was observed in patients by gastroscopy and EUS in 1 to 20 months followed-up time.Conclusion STER for esophageal tumors originating from muscularis propria is a safe、efficient and feasible method of high clinical application value,and it can provide Accurate pathological diagnosis.