Submucosal Tunneling Endoscopic Resection vs Thoracoscopic Enucleation for Large Submucosal Tumors in the Esophagus and the Esophagogastric Junction - 23/11/17

Abstract |
Background |
Submucosal tunneling endoscopic resection (STER) is regarded as a promising method for resection of submucosal tumors (SMTs); however, little is known about a comprehensive comparison of STER and thoracoscopic enucleation (TE). The aim of this study was to compare the clinical outcomes of STER and TE for large symptomatic SMTs in the esophagus and esophagogastric junction, as well as to analyze the factors that affect the feasibility and safety of STER.
Study Design |
We enrolled 166 patients with large symptomatic SMTs in the esophagus and esophagogastric junction from September 2011 to March 2016 in this retrospective study. The clinicopathologic features and treatment results were collected and analyzed.
Results |
En bloc resection was achieved in 84.6% of the patients in the STER group and 86.7% of the patients in the TE group (p = 0.708). Notably, the procedure time and hospital stay in the STER group were considerably shorter than those in the TE group. Tumor transverse diameter is a significant risk factor for piecemeal resection, adverse events, and technical difficulties. No recurrence or metastasis was found during a mean follow-up period of more than 2 years.
Conclusions |
Submucosal tunneling endoscopic resection is effective and safe for large SMTs in the esophagus and esophagogastric junction. This procedure has the advantage of being more minimally invasive with a shorter procedure time and hospital stay compared with TE. Submucosal tunneling endoscopic resection for tumors with a transverse diameter ≥3.5 cm and an irregular shape is associated with relatively high risk for piecemeal resection, adverse events, and technical difficulties.
Le texte complet de cet article est disponible en PDF.Abbreviations and Acronyms : EGJ, ESD, GIST, MP, SMT, STER, TE
Plan
| Disclosure Information: Nothing to disclose. |
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| Support: This study was supported by the National Natural Science Foundation of China (81370588) and Shanghai Committee of Science and Technology (17140901100, 15JC1490300, and 14441901500). |
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| Drs T Chen and Z-W Lin contributed equally to this work. |
Vol 225 - N° 6
P. 806-816 - décembre 2017 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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