Abstract: 【Abstract】Objective:To evaluate the clinical efficacy of submucosal tunnel endoscopic resection (STER) for upper gastrointestinal muscularis propria submucosal tumors (SMTs) with diameter≥3.5 cm.
Methods The clinical data of 14 patients with SMTs≥3.5 cm who were admitted to the Second Xiangya Hospital of Central South University between October 2011 and July 2014 were retrospectively analyzed, including 13 patients with tumor at esophagus and 1 patient with tumor at cardia. All patients underwent STER and the observed indexes included operation tine, tumor location and diameter, results of pathological examination and occurrence of post operative complications. All patients were followed up regularly at the outpatient department including reexamination of gastroscopy, endoscopic ultrasonography(EUS) and computed tomography (CT) till August 2014. 〖HQK〗Measurement data with normal distribution were presented as average (range).
Results:All the 14 patients underwent STER successfully with mean operation time of 83 minutes (range, 60-160 minutes). Fourteen tumors were exited, with 13 located at esophagus and 1 at gastric cardia. En bloc resection was achieved in 13 patients and the tumors were extracted through the tunnel. The tumor in the remaining 1 patient was large with a diameter of 5.3 cm and close to trachea, it was extracted by 2 pieces. The average diameter of 14 tumors extracted was 4.1 cm and postoperative pathological examination confirmed the tumors as leiomyomas. Three patients had postoperative complications, subcutaneous emphysema occurred in 1 patient and retrosternal pain in 1 patient. One patient suffered mucosal laceration and recovered after a metal stent was inserted for 2 weeks. The average duration of postoperative hospital stay was 6.4 days (range, 4.0-8.0 days) .All patients were followed up for a median time of 11.5 months (range, 1.0-24.0 months) with no recurrence.
Conclusion:STER is a safe and effective method for SMTs with diameter≥3.5 cm.