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Peroral endoscopic tumor resection (POET) with preserved mucosa technique for management of upper gastrointestinal tract subepithelial tumors

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Abstract

Background

Third space endoscopy technique facilitates therapeutic endoscopy in subepithelial space. This study aimed to investigate peroral endoscopic tumor resection (POET) with preserved mucosa technique for upper gastrointestinal tract subepithelial tumors (UGI-SETs) removal.

Methods

Between February 2011 and December 2019, consecutive patients with SETs of esophagus and stomach who underwent POET for enlarging size during follow-up, malignant endoscopic ultrasound features or by patient’s request were enrolled. Demographic, endoscopic and pathological data were analyzed retrospectively.

Results

Totally 18 esophageal (mean ± SD age, 55.23 ± 4.15 year-old, 38.89% female) and 30 gastric (52.65 ± 2.43 year-old, 53.33% female) SETs in 47 patients (one with both esophageal and gastric lesions) were resected. The mean (± SD) endoscopic/pathological tumor size, procedure time, en-bloc/complete resection rate, and hospital stays of esophageal and gastric SET patients were 12.36 (± 7.89)/11.86 (± 5.67) and 12.57 (± 6.25)/12.35 (± 5.73) mm, 14.86 (± 6.15) and 38.21 (± 15.29) minutes, 88.89%/94.44% and 86.77%/93.30%, and 4.14 (± 0.21) and 4.17 (± 0.20) days, respectively. The overall complication rate was 18.75%, including 6 self-limited fever and 3 pneumoperitoneum relieved by needle puncture. There was no mortality or recurrence reported with mean follow-up period of 23.74 (± 4.12) months.

Conclusions

POET is a safe and efficient third space endoscopic resection technique for removal of UGI-SETs less than 20 mm. Long term data are warranted to validate these results.

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Acknowledgements

We thank Jung-Chin Li for providing illustrations of endoscopic procedures.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC

    Chen-Shuan Chung, Kuan-Chih Chen, Tzong-Hsi Lee & Cheng-Kuan Lin

  2. Ultrasonography and Endoscopy Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC

    Chen-Shuan Chung

  3. College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, ROC

    Chen-Shuan Chung

  4. Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC

    Kuo-Hsin Chen & Jiann-Ming Wu

  5. Division of Gastroenterology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, ROC

    Chiung-Yu Chen

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  1. Chen-Shuan Chung
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Contributions

Study concept and design: C-SC, K-CC, J-MW. Analysis and interpretation of data: C-SC, K-CC, C-YC, J-MW. Critical revision of the manuscript for important intellectual content: C-SC, K-CC, J-MW, K-HC, T-HL, C-YC, C-KL. Statistical analysis: C-SC. Obtained funding: C-SC. Administrative, technical or material support: C-SC, J-MW, C-KL.

Corresponding author

Correspondence to Jiann-Ming Wu.

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Disclosure

Drs. Chen-Shuan Chung, Kuo-Hsin Chen, Kuan-Chih Chen, Chiung-Yu Chen, Tzong-Hsi Lee, Cheng-Kuan Lin, and Jiann-Ming Wu have no conflicts of interest or financial ties to disclose.

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Chung, CS., Chen, KH., Chen, KC. et al. Peroral endoscopic tumor resection (POET) with preserved mucosa technique for management of upper gastrointestinal tract subepithelial tumors. Surg Endosc 35, 3753–3762 (2021). https://doi.org/10.1007/s00464-020-07868-y

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