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Endoscopic Full-Thickness Resection (EFTR) and Submucosal Tunneling Endoscopic Resection (STER)

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Abstract

This chapter focuses on the detailed descriptions of two advanced therapeutic endoscopic techniques: endoscopic full-thickness resection (EFTR) and submucosal tunneling endoscopic resection (STER) for gastrointestinal subepithelial tumors, including indications and contraindications, the procedure steps, procedure-related adverse events, and clinical outcomes. Various approaches for closing the iatrogenic GI wall perforation are highlighted in this chapter.

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References

  1. Sakamoto H, Kitano M, Kudo M. Diagnosis of subepithelial tumors in the upper gastrointestinal tract by endoscopic ultrasonography. World J Radiol. 2010;2:289–97.

    Article  PubMed  PubMed Central  Google Scholar 

  2. North JH, Pack MS. Malignant tumors of the small intestine: a review of 144 cases. Am Surg. 2000;66:46–51.

    CAS  PubMed  Google Scholar 

  3. Seno K, Itoh M, Endoh K, et al. Schwannoma of the duodenum causing melena. Intern Med. 1994;33:621–3.

    Article  CAS  PubMed  Google Scholar 

  4. Cesaretti M, Sulpice L, Farges O. Gastrointestinal bleeding from a submucosal duodenal tumor. Surgery. 2016;159:670–1.

    Article  PubMed  Google Scholar 

  5. Rosch T, Sarbia M, Schumacher B, et al. Attempted endoscopic en bloc resection of mucosal and submucosal tumors using insulated-tip knives: a pilot series. Endoscopy. 2004;36:788–801.

    Article  CAS  PubMed  Google Scholar 

  6. Shi Q, Zhong YS, Yao LQ, et al. Endoscopic submucosal dissection for treatment of esophageal submucosal tumors originating from the muscularis propria layer. Gastrointest Endosc. 2011;74:1194–200.

    Article  PubMed  Google Scholar 

  7. Li QL, Yao LQ, Zhou PH, et al. Submucosal tumors of the esophagogastric junction originating from the muscularis propria layer: a large study of endoscopic submucosal dissection (with video). Gastrointest Endosc. 2012;75:1153–8.

    Article  PubMed  Google Scholar 

  8. Sumiyama K, Gostout CJ. Novel techniques and instrumentation for EMR, ESD, and full-thickness endoscopic luminal resection. Gastrointest Endosc Clin N Am. 2007;17:471–85.

    Article  PubMed  Google Scholar 

  9. Bialek A, Wiechowska-Kozlowska A, Huk J. Endoscopic submucosal dissection of large gastric stromal tumor arising from muscularis propria. Clin Gastroenterol Hepatol. 2010;8:119–20.

    Article  Google Scholar 

  10. Chun SY, Kim KO, Park DS, et al. Endoscopic submucosal dissection as a treatment for gastric subepithelial tumors that originate from the muscularis propria layer: a preliminary analysis of appropriate indications. Surg Endosc. 2013;27:3271–9.

    Article  PubMed  PubMed Central  Google Scholar 

  11. He Z, Sun C, Wang J, et al. Efficacy and safety of endoscopic submucosal dissection in treating gastric subepithelial tumors originating in the muscularis propria layer: a single-center study of 144 cases. Scand J Gastroenterol. 2013;48:1466–73.

    Article  PubMed  Google Scholar 

  12. Lee IL, Lin PY, Tung SY, et al. Endoscopic submucosal dissection for the treatment of intraluminal gastric subepithelial tumors originating from the muscularis propria layer. Endoscopy. 2006;38:1024–8.

    Article  PubMed  Google Scholar 

  13. Li L, Wang F, Wu B, et al. Endoscopic submucosal dissection of gastric fundus subepithelial tumors originating from the muscularis propria. Exp Ther Med. 2013;6:391–5.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Meng FS, Zhang ZH, Shan GD, et al. Endoscopic submucosal dissection for the treatment of large gastric submucosal tumors originating from the muscularis propria layer: a single center study. Z Gastroenterol. 2015;53:655–9.

    Article  CAS  PubMed  Google Scholar 

  15. Zhang S, Chao GQ, Li M, et al. Endoscopic submucosal dissection for treatment of gastric submucosal tumors originating from the muscularis propria layer. Dig Dis Sci. 2013;58:1710–6.

    Article  PubMed  Google Scholar 

  16. Liu BR, Song JT, Qu B, et al. Endoscopic muscularis dissection for upper gastrointestinal subepithelial tumors originating from the muscularis propria. Surg Endosc. 2012;26:3141–8.

    Article  PubMed  Google Scholar 

  17. Chu YY, Lien JM, Tsai MH, et al. Modified endoscopic submucosal dissection with enucleation for treatment of gastric subepithelial tumors originating from the muscularis propria layer. BMC Gastroenterol. 2012;12:124.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Reinehr R. Endoscopic submucosal excavation (ESE) is a safe and useful technique for endoscopic removal of submucosal tumors of the stomach and the esophagus in selected cases. Z Gastroenterol. 2015;53:573–8.

    Article  CAS  PubMed  Google Scholar 

  19. Ye LP, Zhu LH, Zhou XB, et al. Endoscopic excavation for the treatment of small esophageal subepithelial tumors originating from the muscularis propria. Hepato-Gastroenterology. 2015;62:65–8.

    PubMed  Google Scholar 

  20. Huang Q, Zhu LH, et al. Endoscopic excavation for gastric heterotopic pancreas: an analysis of 42 cases from a tertiary center. Wien Klin Wochenschr. 2014;126:509–14.

    Article  PubMed  Google Scholar 

  21. Zhang Y, Ye LP, Zhou XB, et al. Safety and efficacy of endoscopic excavation for gastric subepithelial tumors originating from the muscularis propria layer: results from a large study in China. J Clin Gastroenterol. 2013;47:689–94.

    Article  PubMed  Google Scholar 

  22. Zhang Y, Ye LP, Zhu LH, et al. Endoscopic muscularis excavation for subepithelial tumors of the esophagogastric junction originating from the muscularis propria layer. Dig Dis Sci. 2013;58:1335–40.

    Article  PubMed  Google Scholar 

  23. Suzuki H, Okuwaki S, Ikeda K, et al. Endoscopic full-thickness resection (EFTR) and waterproof defect closure (ENDC) for improvement of curability and safety in endoscopic treatment of early gastrointestinal malignancies. Prog Dig Endosc. 1998;52:49–53.

    Google Scholar 

  24. Zhou PH, Yao LQ, Qin XY, et al. Endoscopic full-thickness resection without laparoscopic assistance for gastric submucosal tumors originated from the muscularis propria. Surg Endosc. 2011;25:2926–31.

    Article  PubMed  Google Scholar 

  25. Xu M, Wang XY, Zhou PH, et al. Endoscopic full-thickness resection of colonic submucosal tumors originating from the muscularis propria: an evolving therapeutic strategy. Endoscopy. 2013;45:770–3.

    Article  PubMed  Google Scholar 

  26. Huang LY, Cui J, Lin SJ, et al. Endoscopic full-thickness resection for gastric submucosal tumors arising from the muscularis propria layer. World J Gastroenterol. 2014;20:13981–6.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Feng Y, Yu L, Yang S, et al. Endolumenal endoscopic full-thickness resection of muscularis propria-originating gastric submucosal tumors. J Laparoendosc Adv Surg Tech A. 2014;24(3):171–6.

    Article  PubMed  Google Scholar 

  28. Yang F, Wang S, Sun S, et al. Factors associated with endoscopic full-thickness resection of gastric submucosal tumors. Surg Endosc. 2015;29:3588–93.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Guo J, Liu Z, Sun S, et al. Endoscopic full-thickness resection with defect closure using an over-the-scope clip for gastric subepithelial tumors originating from the muscularis propria. Surg Endosc. 2015;29:3356.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Wang L, Ren W, Fan CQ, et al. Full-thickness endoscopic resection of nonintracavitary gastric stromal tumors: a novel approach. Surg Endosc. 2011;25:641–7.

    Article  PubMed  Google Scholar 

  31. Walz MK, Alesina PF, Wenger FA, et al. Laparoscopic and retroperitoneoscopic treatment of pheochromocytomas and retroperitoneal paragangliomas: results of 161 tumors in 126 patients. World J Surg. 2006;30:899–908.

    Article  PubMed  Google Scholar 

  32. Schmidt A, Meier B, Caca K. Endoscopic full-thickness resection: current status. World J Gastroenterol. 2015;21:9273–85.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Zhou PH, Yao LQ, Qin XYE. Endoscopic full-thickness resection (EFTR). In: Atlas of digestive endoscopic resection. Netherlands: Springer; 2014. p. 218–39.

    Chapter  Google Scholar 

  34. Abe N, Takeuchi H, Shibuya M, et al. Successful treatment of duodenal carcinoid tumor by laparoscopy-assisted endoscopic full-thickness resection with lymphadenectomy. Asian J Endosc Surg. 2012;5:81–5.

    Article  CAS  PubMed  Google Scholar 

  35. Schmidt A, Meier B, Cahyadi O, et al. Duodenal endoscopic full- thickness resection (with video). Gastrointest Endosc. 2015;82:728–33.

    Article  PubMed  Google Scholar 

  36. Schmidt A, Damm M, Caca K. Endoscopic full-thickness resection using a novel over-the-scope device. Gastroenterology. 2014;147:740–2.

    Article  PubMed  Google Scholar 

  37. Fahndrich M, Sandmann M. Endoscopic full-thickness resection for gastrointestinal lesions using the over-the-scope clip system: a case series. Endoscopy. 2015;47:76–9.

    PubMed  Google Scholar 

  38. Schmidt A, Bauerfeind P, Gubler C, et al. Endoscopic full-thickness resection in the colorectum with a novel over-the-scope device: first experience. Endoscopy. 2015;47:719–25.

    Article  PubMed  Google Scholar 

  39. Richter-Schrag HJ, Walker C, Thimme R, et al. Full thickness resection device (FTRD). Experience and outcome for benign neoplasms of the rectum and colon. Chirurg. 2016;87:316–25.

    Article  PubMed  Google Scholar 

  40. Andrisani G, Pizzicannella M, Martino M, et al. Endoscopic full-thickness resection of superficial colorectal neoplasms using a new over the- scope clip system: a single-centre study. Dig Liver Dis. 2017;49:1009–13.

    Article  PubMed  Google Scholar 

  41. Al-Bawardy B, Rajan E, Wong Kee Song LM. Over-the-scope clip-assisted endoscopic full-thickness resection of epithelial and subepithelial GI lesions. Gastrointest Endosc. 2017;85:1087–92.

    Article  PubMed  Google Scholar 

  42. Dinelli M, Omazzi B, Andreozzi P, et al. First clinical experiences with a novel endoscopic over-the-scope clip system. Endosc Int Open. 2017;5:151–6.

    Article  Google Scholar 

  43. Schmidt AR, Meining A, Birk M, et al. Abstract no. 54: endoscopic full-thickness resection in the colorectum using an over-the-scope device—interim results of a prospective multicenter study. Gastrointest Endosc. 2016;83.(Suppl:AB119.

    Article  Google Scholar 

  44. Vitali F, Naegel A, Siebler J, Neurath MF, Rath T. Endoscopic full-thickness resection with an over-the-scope clip device (FTRD) in the colorectum: results from a university tertiary referral center. Endosc Int Open. 2018;6(1):98–103.

    Article  Google Scholar 

  45. Schostek S, Ho CN, Melbert M, et al. DC current pulses for OTSC clip fragmentation: technology and experimental study. Surg Endosc. 2015;29:2418–22.

    Article  PubMed  Google Scholar 

  46. Schmidt A, Riecken B, Damm M, et al. Endoscopic removal of over-the-scope clips using a novel cutting device: a retrospective case series. Endoscopy. 2014;46:762–6.

    Article  PubMed  Google Scholar 

  47. Aepli P, Criblez D, Baumeler S, et al. Endoscopic full thickness resection (EFTR) of colorectal neoplasms with the full thickness resection device (FTRD): clinical experience from two tertiary referral centers in Switzerland. United Euro Gastro J. 2018;6(3):463–70.

    Article  Google Scholar 

  48. Joensuu H. Risk stratification of patients diagnosed with gastrointestinal stromal tumor. Hum Pathol. 2008;39:1411–9.

    Article  PubMed  Google Scholar 

  49. Casali PG, Jost L, Reichardt P, et al. Gastrointestinal stromal tumours: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol. 2009;20:64–7.

    PubMed  Google Scholar 

  50. Blackstein ME, Blay JY, Corless C, et al. Gastrointestinal stromal tumours: consensus statement on diagnosis and treatment. Can J Gastroenterol. 2006;20:157–63.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Fukami Y, Kurumiya Y, Mizuno K, et al. A 12-mm carcinoid tumor of the minor duodenal papilla with lymph node metastases. Jpn J Clin Oncol. 2013;43:74–7.

    Article  PubMed  Google Scholar 

  52. Demetri GD, Benjamin RS, Blanke CD, et al. NCCN task force report: optimal management of patients with gastrointestinal stromal tumor (GIST)—update of NCCN clinical practice guidelines. J Natl Compr Cancer Netw. 2007:1–26.

    Google Scholar 

  53. Soga J. Endocrinocarcinomas (carcinoids and their variants) of the duodenum. An evaluation of 927 cases. J Exp Clin Cancer Res. 2003;22:349–63.

    CAS  PubMed  Google Scholar 

  54. Binmoeller KF, Grimm H, Soehendra N. Endoscopic closure of a perforation using metallic clips after snare excision of a gastric leiomyoma. Gastrointest Endosc. 1993;39(2):172–4.

    Article  CAS  PubMed  Google Scholar 

  55. Minami S, Gotoda T, Ono H, Oda I, Hamanaka H. Complete endoscopic closure of gastric perforation induced by endoscopic resection of early gastric cancer using endoclips can prevent surgery (with video). Gastrointest Endosc. 2006;63(4):596–601.

    Article  PubMed  Google Scholar 

  56. Matsuda T, Fujii T, Emura F, Kozu T, Saito Y, Ikematsu H, et al. Complete closure of a large defect after EMR of a lateral spreading colorectal tumor when using a two-channel colonoscope. Gastrointest Endosc. 2004;60(5):836–8.

    Article  PubMed  Google Scholar 

  57. Shi Q, Chen T, Zhong YS, Zhou PH, Ren Z, Xu MD, et al. Complete closure of large gastric defects after endoscopic full-thickness resection, using endoloop and metallic clip interrupted suture. Endoscopy. 2013;45(5):329–34.

    Article  CAS  PubMed  Google Scholar 

  58. Hashiba K, Carvalho AM, Diniz G Jr, Barbosa de Aridrade N, Guedes CA, Siqueira Filho L, et al. Experimental endoscopic repair of gastric perforations with an omental patch and clips. Gastrointest Endosc. 2001;54(4):500–4.

    Article  CAS  PubMed  Google Scholar 

  59. Dray X, Giday SA, Buscaglia JM, Gabrielson KL, Kantsevoy SV, Magno P, et al. Omentoplasty for gastrotomy closure after natural orifice transluminal endoscopic surgery procedures (with video). Gastrointest Endosc. 2009;70(1):131–40.

    Article  PubMed  Google Scholar 

  60. Kratt T, Kuper M, Traub F, Ho CN, Schurr MO, Konigsrainer A, et al. Feasibility study for secure closure of natural orifice transluminal endoscopic surgery gastrotomies by using over-the-scope clips. Gastrointest Endosc. 2008;68(5):993–6.

    Article  PubMed  Google Scholar 

  61. Kirschniak A, Kratt T, Stuker D, Braun A, Schurr MO, Konigsrainer A. A new endoscopic over-the-scope clip system for treatment of lesions and bleeding in the GI tract: first clinical experiences. Gastrointest Endosc. 2007;66(1):162–7.

    Article  PubMed  Google Scholar 

  62. Ozawa S, Yoshida M, Kumai K, Kitajima M. New endoscopic treatments for gastroesophageal reflux disease. Ann Thorac Cardiovasc Surg. 2005;11:146–53.

    PubMed  Google Scholar 

  63. Ye LP, Yu Z, Mao XL, Zhu LH, Zhou XB. Endoscopic full-thickness resection with defect closure using clips and an endoloop for gastric subepithelial tumors arising from the muscularis propria. Surg Endosc. 2014;28:1978–83.

    Article  PubMed  Google Scholar 

  64. Zhang Y, Wang X, Xiong G, Qian Y, Wang H, Liu L, Miao L, Fan Z. Complete defect closure of gastric submucosal tumors with purse-string sutures. Surg Endosc. 2014;28:1844–51.

    Article  PubMed  Google Scholar 

  65. Moran EA, Gostout CJ, Bingener J. Preliminary performance of a flexible cap and catheter-based endoscopic suturing system. Gastrointest Endosc. 2009;69:1375–83.

    Article  PubMed  Google Scholar 

  66. Chiu PW, Phee SJ, Wang Z, Sun Z, Poon CC, Yamamoto T, Penny I, Wong JY, Lau JY, Ho KY. Feasibility of full-thickness gastric resection using master and slave transluminal endoscopic robot and closure by Overstitch: a preclinical study. Surg Endosc. 2014;28:319–24.

    Article  PubMed  Google Scholar 

  67. Kantsevoy SV, Bitner M, Mitrakov AA, Thuluvath PJ. Endoscopic suturing closure of large mucosal defects after endoscopic submucosal dissection is technically feasible, fast, and eliminates the need for hospitalization (with videos). Gastrointest Endosc. 2014;79:503–7.

    Article  PubMed  Google Scholar 

  68. Rajan E, Gostout CJ, Bonin EA, Moran EA, Locke RG, Szarka LA, Talley NJ, Deters JL, Miller CA, Knipschield MA, Lurken MS, Stotlz GJ, Bernard CE, Grover M, Farrugia G. Endoscopic full-thickness biopsy of the gastric wall with defect closure by using an endoscopic suturing device: survival porcine study. Gastrointest Endosc. 2012;76:1014–9.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Schmidt A, Bauder M, Riecken B, Caca K. Endoscopic resection of subepithelial tumors. World J Gastrointest Endosc. 2014;6:592–9.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Mahmood Z, Ang YS. EndoCinch treatment for gastro-oesophageal reflux disease. Digestion. 2007;76:241–7.

    Article  CAS  PubMed  Google Scholar 

  71. Mori H, Kobara H, Fujihara S, Nishiyama N, Rafiq K, Oryu M, Fujiwara M, Suzuki Y, Masaki T. Feasibility of pure EFTR using an innovative new endoscopic suturing device: the double-arm-bar suturing system (with video). Surg Endosc. 2014;28:683–90.

    Article  PubMed  Google Scholar 

  72. Sumiyama K, Gostout CJ, Rajan E, Bakken TA, Deters JL, Knipschield MA. Endoscopic full-thickness closure of large gastric perforations by use of tissue anchors. Gastrointest Endosc. 2007;65(1):134–9.

    Article  PubMed  Google Scholar 

  73. Xu MD, Cai MY, Zhou PH, et al. Submucosal tunneling endoscopic resection: a new technique for treating upper GI submucosal tumors originating from the muscularis propria layer (with videos). Gastrointest Endosc. 2012;75:195–9.

    Article  PubMed  Google Scholar 

  74. Zhang C, Hu JW, Chen T, et al. Submucosal tunnelling endoscopic resection for upper gastrointestinal multiple submucosal tumors originating from the muscular propria layer. A feasibility study. Indian J Cancer. 2014;51:52–5.

    Article  Google Scholar 

  75. Lu J, Jiao T, Zheng M, et al. Endoscopic resection of submucosal tumors in muscularis propria: the choice between direct excavation and tunneling resection. Surg Endosc. 2014;28:3401–7.

    Article  PubMed  Google Scholar 

  76. Tao C, Zhou PH, Chu Y, et al. Long-term outcomes of submucosal tunneling endoscopic resection for upper gastrointestinal submucosal tumors. Ann Surg. 2017;265:363–9.

    Article  Google Scholar 

  77. Jeong ES, Hong SJ, Han JP, Kwak JJ. Submucosal tunneling endoscopic resection of a leiomyoma originating from the muscularis propria of the gastric cardia (with video). Korean J Gastroenterol. 2015;66:340–4.

    Article  PubMed  Google Scholar 

  78. Lu J, Zheng M, Jiao T, Wang Y, Lu X. Transcardiac tunneling technique for endoscopic submucosal dissection of gastric fundus tumors arising from the muscularis propria. Endoscopy. 2014;46:888–92.

    Article  PubMed  Google Scholar 

  79. Li QL, Chen WF, Zhang C, et al. Clinical impact of submucosal tunneling endoscopic resection for the treatment of gastric submucosal tumors originating from the muscularis propria layer (with video). Surg Endosc. 2015;29:3640–6.

    Article  PubMed  Google Scholar 

  80. Zhou DJ, Dai ZB, Wells MM, Yu DL, Zhang J, Zhang L. Submucosal tunneling and endoscopic resection of submucosal tumors at the esophagogastric junction. World J Gastroenterol. 2015;21:578–83.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Wang XY, Xu MD, Yao LQ, et al. Submucosal tunneling endoscopic resection for submucosal tumors of the esophagogastric junction originating from the muscularis propria layer: a feasibility study (with videos). Surg Endosc. 2014;28:1971–7.

    Article  PubMed  Google Scholar 

  82. Tan Y, Lv L, Duan T, et al. Comparison between submucosal tunneling endoscopic resection and video-assisted thoracoscopic surgery for large esophageal leiomyoma originating from the muscularis propria layer. Surg Endosc. 2016;30:3121–7.

    Article  PubMed  Google Scholar 

  83. Liu H, Wei LL, Zhang YZ, et al. Submucosal tunnelling endoscopic resection (STER) for the treatment of a case of huge esophageal tumor arising in the muscularis propria: a case report and review of literature. Int J Clin Exp Med. 2015;8:15846–51.

    PubMed  PubMed Central  Google Scholar 

  84. Wang H, Tan Y, Zhou Y, et al. Submucosal tunneling endoscopic resection for upper gastrointestinal submucosal tumors originating from the muscularis propria layer. Eur J Gastroenterol Hepatol. 2015;27:776–80.

    Article  PubMed  Google Scholar 

  85. Ye LP, Zhang Y, Mao XL, Zhu LH, Zhou X, Chen JY. Submucosal tunneling endoscopic resection for small upper gastrointestinal subepithelial tumors originating from the muscularis propria layer. Surg Endosc. 2014;28:524–30.

    Article  PubMed  Google Scholar 

  86. Chen T, Zhang C, Yao LQ, et al. Management of the complications of submucosal tunneling endoscopic resection for upper gastrointestinal submucosal tumors. Endoscopy. 2016;48:149–55.

    PubMed  Google Scholar 

  87. Inoue H, Ikeda H, Hosoya T, et al. Submucosal endoscopic tumor resection for subepithelial tumors in the esophagus and cardia. Endoscopy. 2012;44:225–30.

    Article  CAS  PubMed  Google Scholar 

  88. Costache M-I, Iordache S, Karstensen JG, Săftoiu A, Vilmann P. Endoscopic ultrasound-guided fine needle aspiration: from the past to the future. Endosc Ultrasound. 2013;2(2):77–85.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Chen H, Xu Z, Huo J, Liu D. Submucosal tunneling endoscopic resection for simultaneous esophageal and cardia submucosal tumors originating from the muscularis propria layer (with video). Dig Endosc. 2015;27:155–8.

    Article  PubMed  Google Scholar 

  90. Cai MY, Zhu BQ, Qin WZ, et al. Submucosal tunnel endoscopic resection for extraluminal tumors: a novel endoscopic method for en bloc resection of predominant extraluminal growing subepithelial tumors or extra-gastrointestinal tumors (with videos). Gastrointest Endosc. 2018;2:160. https://doi.org/10.1016/j.gie.2018.02.032.

    Article  Google Scholar 

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Authors and Affiliations

  1. Endoscopy Center, Zhongshan Hospital of Fudan University, Shanghai, China

    Mingyan Cai & Pinghong Zhou

  2. Department of Gastroenterology, Royal Adelaide Hospital, Adelaide, SA, Australia

    Marie Ooi

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  1. Mingyan Cai
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  2. Marie Ooi
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  3. Pinghong Zhou
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Correspondence to Pinghong Zhou .

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Editors and Affiliations

  1. Interventional Endoscopy, Division of Gastroenterology, University of Colorado-Denver, Aurora, CO, USA

    Mihir S. Wagh

  2. Interventional Endoscopy, Division of Gastroenterology, University of Colorado-Denver, Aurora, CO, USA

    Sachin B. Wani

Electronic Supplementary Materials

demonstrates the steps of EFTR for a gastric subepithelial tumor at the greater curvature. Pure-string suture technique by endoloop and clips is also demonstrated (MOV 201537 kb)

shows a case of esophageal subepithelial tumor treated by STER technique. The tumor was originating from muscularis propria (MOV 102765 kb)

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Cai, M., Ooi, M., Zhou, P. (2020). Endoscopic Full-Thickness Resection (EFTR) and Submucosal Tunneling Endoscopic Resection (STER). In: Wagh, M., Wani, S. (eds) Gastrointestinal Interventional Endoscopy. Springer, Cham. https://doi.org/10.1007/978-3-030-21695-5_9

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