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Surgical Endoscopy

, Volume 32, Issue 11, pp 4543–4551 | Cite as

Treatment of cardial submucosal tumors originating from the muscularis propria layer: submucosal tunneling endoscopic resection versus endoscopic submucosal excavation

  • Chen Du
  • Ningli Chai
  • Enqiang LinghuEmail author
  • Ying Gao
  • Zhenjuan Li
  • Longsong Li
  • Yaqi Zhai
  • Zhongsheng Lu
  • Jiangyun Meng
  • Ping Tang
Article

Abstract

Background and aims

Submucosal tunneling endoscopic resection (STER) is increasingly used for the treatment of submucosal tumors (SMTs) originating from the muscularis propria layer; however, endoscopic submucosal excavation (ESE) is still performed in many hospitals for its low-skill and experience requirements. This study aimed to compare STER with ESE for cardial SMTs.

Methods

From March 2013 to February 2017, patients with cardial SMTs undergoing STER (n = 47) and ESE (n = 40) were retrospectively assessed. Clinicopathological, endoscopic, and complication data were compared between STER and ESE groups.

Results

The 87 enrolled patients included 31 females and 56 males, aged 48.2 ± 9.8 years. Mean tumor size was 22.0 mm (range 5.0–80.0 mm) as evaluated by pathology. Demographic and lesion features were similar in both groups. Despite similar hospital stay duration and cost, ESE was superior to STER with reduced operation time (34 vs. 46 min, P = 0.013) and less clips required (3 vs. 5, P = 0.000). En bloc resection rates, complete resection rates, hospital stay duration, cost, complications, and hemoglobin levels were similar in both groups. Irregular-shaped SMTs were more likely to achieve piecemeal resection in both STER and ESE groups (all P < 0.05). Meanwhile, the piecemeal resection rate was significantly higher for larger tumors in the STER group.

Conclusion

Compared with ESE, STER does not show overt advantages for cardial SMTs. However, ESE is superior to STER for reduced operation time. Irregular tumor shape seems to be a risk factor for piecemeal resection in both STER and ESE.

Keywords

Submucosal tunneling endoscopic resection Endoscopic submucosal excavation Submucosal tumor Muscularis propria 

Notes

Acknowledgements

This study was supported by research grants from two Chinese PLA General Hospital Clinical Researches (2012FC-TSYS-3035 and YS201404).

Compliance with ethical standards

Disclosures

Drs. Chen Du, Ningli Chai, Enqiang Linghu, Ying Gao, Zhenjuan Li, Longsong Li, Yaqi Zhai, Zhongsheng Lu, Jiangyun Meng, and Ping Tang have no conflicts of interest or financial ties to disclose.

Supplementary material

Supplementary material 1 (MP4 321824 KB)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Gastroenterology and HepatologyChinese PLA General HospitalBeijingChina

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