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The retrospective comparison between submucosal tunneling endoscopic resection and endoscopic submucosal excavation for managing esophageal submucosal tumors originating from the muscularis propria layer

  • Yingtong Chen
  • Min Wang
  • Lili ZhaoEmail author
  • He Chen
  • Li Liu
  • Xiang Wang
  • Zhining FanEmail author
Article

Abstract

Background

Submucosal tunneling endoscopic resection (STER) and endoscopic submucosal excavation (ESE) were recently introduced to cure submucosal tumors (SMTs) originating from the muscularis propria (MP) layer. This study aimed to compare clinical performance and safety of STER and ESE in treating esophageal SMTs originating from the MP layer.

Methods

From January 2011 to December 2017, retrospective data collection and follow-up were applied for all STER or ESE cases with esophageal SMTs originating from the MP layer in our endoscopy center, including clinical characteristics, procedure success, efficacy, and adverse events. Subgroup analysis was further done based on tumor size and origin.

Results

90 STER and 77 ESE were enrolled in this study. There were no significant difference for  patient characteristics, procedure performance, and complications for ESE and STER intervention (P > 0.05). STER was faster than ESE (3.90 mm2/min vs 2.82 mm2/min, P < 0.05). For large tumors (≥ 20 mm), both techniques had the similar performance (P > 0.05), while STER led to the shorter hospitalization (4.0d vs 7.0d, P < 0.05) and lower postoperative complication (16.3% vs 45.5%, P < 0.05). For small tumors (< 20 mm), STER achieved faster operation (STER vs ESE, 2.57 mm2/min vs 1.83 mm2/min, P < 0.05). Regardless of tumor origin, there were no significant difference for both techniques, but STER resulted in short hospitalization for SMTs from the deep MP layer (STER vs ESE, 5.0d vs 7.0d, P < 0.05). During the follow-up, 2 residual and 4 recurrence occurred in the STER group, as well as 1 residual and 2 recurrence in the ESE group.

Conclusions

Both STER and ESE were effective for treating esophageal SMTs originating from the MP layer. STER might be better due to its faster operation, less complications, and shorter hospitalization.

Keywords

Submucosal tunneling endoscopic resection (STER) Endoscopic submucosal excavation (ESE) Esophageal submucosal tumors (SMTs) The muscularis propria (MP) layer Comparison 

Notes

Acknowledgements

This study was funded by Jiangsu Province “333” project (BRA2015463); The Priority Academic Program Development of Jiangsu Higher Education Institutions (JX10231802); Jiangsu Province Key technology research Program (BE2016738); The Key Medical Program of Jiangsu Province (ZDXKA2016005); and National Natural Science Foundation of China (81700577).

Compliance with ethical standards

Disclosures

Drs. Yingtong Chen, Min Wang, Lili Zhao, He Chen, Li Liu, Xiang Wang, and Zhining Fan have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Digestive Endoscopy DepartmentThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
  2. 2.Department of General SurgeryThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina

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