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Submucosal tunneling endoscopic resection for leiomyomas located on opposite esophageal walls: the role of a tortuous submucosal tunnel.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Zhou, Fenglian Tan, Yuyong Chu, Yi Min Hu, Changmei Huo, Jirong Liu, Deliang L. |
| Copyright Year | 2016 |
| Abstract | A 50-year-old man presented to our hospital with a 1-month history of epigastric discomfort. Esophagogastroduodenoscopy (EGD) revealed two protruding lesions on the anterior and posterior esophageal walls, about 27cm and 30cm from the incisors, respectively (●" Fig.1a;●" Video1). Endoscopic ultrasonography (EUS) revealed that the tumors were originating from the muscularis propria layer and had no risk features. Submucosal tunneling endoscopic resection (STER) was performed. After a longitudinal mucosal incision had been made, a submucosal tunnel was created and the first submucosal tumor (SMT) could be seen (●" Fig.1b). As the two tumors were located on opposite walls of the esophagus, it was impossible to locate the second tumor using purely a straight submucosal tunnel, so a tortuous tunnel was created. Submucosal injection of methylene blue was performed to preset the tunnel route, and the two separate tumors were identified, with a distance of about 3cm between them (●" Fig.1c). The tumors were carefully dissected off the muscularis propria layer (●" Fig.1d), and the mucosal entry was closed (●" Fig.1e; ●" Video2). The STER procedure was completed uneventfully within 80 minutes. The diameters of the resected SMTs were 2cm and 1.5cm (●" Fig.2) and they were both leiomyomas histopathologically. STERhasbeendemonstrated tobesafe and effective for treating upper gastrointestinal SMTs [1,2]. There have been only a few reports regarding STER for multiple SMTs, and the tumors in each of the reported cases were in the same or adjacent parts of the esophageal/gastric wall, so a single submucosal tunnel was sufficient to remove the tumors [3–5]. In the present case, the two SMTswere found onopposite esophageal walls, and at first two submucosal tunnels were recommended. This however would mean excessive submucosal dissection and two tunnel entries, which, as well as being time-consuming, Fig.1 Endoscopic views showing: a two protruding lesions in the esophagus; b the first tumor in the submucosal tunnel; c the second tumor within the same submucosal tunnel; d the wound surface after removal of the two tumors; e the mucosal entry point closed with several clips. |
| Starting Page | 305 |
| Ending Page | 313 |
| Page Count | 9 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://www.thieme-connect.com/products/ejournals/pdf/10.1055/s-0042-111323.pdf |
| PubMed reference number | 27489993v1 |
| Alternate Webpage(s) | https://doi.org/10.1055/s-0042-111323 |
| DOI | 10.1055/s-0042-111323 |
| Journal | Endoscopy |
| Volume Number | 48 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Diameter (qualifier value) Eighty Endoscopic Retrograde Cholangiopancreatography Endoscopic Ultrasound Epigastric discomfort Esophageal Tissue Esophageal motility disorders Esophagogastroduodenoscopy Esophagus Excision Fibroid Tumor Gastrointestinal Diseases Incisor Malaise Methylene blue Mucous Membrane Muscle layer Neoplasms Neoplasms, Second Primary Part Dosing Unit Surgical incisions Upper Gastrointestinal Tract Walls of a building carbene pediatric intracranial germ cell brain tumor |
| Content Type | Text |
| Resource Type | Article |
