PMID- 28842802
OWN - NLM
STAT- MEDLINE
DCOM- 20190802
LR  - 20190802
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
VI  - 32
IP  - 3
DP  - 2018 Mar
TI  - Factors affecting the effectiveness and safety of submucosal tunneling endoscopic 
      resection for esophageal submucosal tumors originating from the muscularis 
      propria layer.
PG  - 1255-1264
LID - 10.1007/s00464-017-5800-x [doi]
AB  - BACKGROUND AND AIMS: Submucosal tunneling endoscopic resection (STER) has been 
      proved to be effective and safe for esophageal submucosal tumors (SMTs) 
      originating from the muscularis propria (MP) layer. This study was aimed to 
      further evaluate the effectiveness, safety, and influencing factors especially 
      the types of mucosal incision of STER in a larger population. METHODS: A total of 
      89 patients undergoing STER with esophageal SMTs were retrospectively enrolled in 
      this study from May 2012 to November 2016. Clinicopathological, endoscopic, and 
      adverse events (AEs) data were collected and analyzed. Different incision methods 
      were compared to evaluate the optimum incision method. RESULTS: There were 27 
      females and 62 males with mean age of 46.5 +/- 10.3 years. The medium size of the 
      tumors was 16.0 mm (ranging 10.0-60.0 mm). Inverted T incisions were made in 29 
      (32.6%) patients, transverse incisions in 12 (13.5%) while longitudinal incisions 
      in 48 (53.9%). En bloc resection was achieved in 70 (78.7%) patients. The 
      residual rate was 1.1% (1/89), and no recurrence was noted even after piecemeal 
      resection. The rate of AEs was 21.3% (19/89), and all of the AEs were cured 
      without intervention or treated conservatively without the need for surgery. The 
      en bloc resection rate was comparable among the three incision groups 
      (P = 0.868); however, the incidence of AEs in the inverted T incision was lower 
      than that in the longitudinal incision (P = 0.003). Fewer clips were used in the 
      inverted T incision group than in the transverse incision group (P = 0.003). 
      CONCLUSIONS: Although STER failed to achieve en bloc resection in 21.3% patients, 
      it was still an effective therapy owing to low residual rate and no recurrence 
      rate after piecemeal resection. STER was safe with no severe AEs; however, minor 
      AEs were common. Inverted T incision seems to be the optimum entry point.
FAU - Du, Chen
AU  - Du C
AD  - Department of Gastroenterology and Hepatology, Chinese People's Liberation Army 
      General Hospital, Fuxing Road 28 Haidian District, Beijing, 100853, China.
FAU - Ma, Lianjun
AU  - Ma L
AD  - Department of Gastroenterology and Hepatology, Chinese People's Liberation Army 
      General Hospital, Fuxing Road 28 Haidian District, Beijing, 100853, China.
FAU - Chai, Ningli
AU  - Chai N
AD  - Department of Gastroenterology and Hepatology, Chinese People's Liberation Army 
      General Hospital, Fuxing Road 28 Haidian District, Beijing, 100853, China.
FAU - Gao, Ying
AU  - Gao Y
AD  - Department of Gastroenterology and Hepatology, Chinese People's Liberation Army 
      General Hospital, Fuxing Road 28 Haidian District, Beijing, 100853, China.
FAU - Niu, Xiaotong
AU  - Niu X
AD  - Department of Gastroenterology and Hepatology, Chinese People's Liberation Army 
      General Hospital, Fuxing Road 28 Haidian District, Beijing, 100853, China.
FAU - Zhai, Yaqi
AU  - Zhai Y
AD  - Department of Gastroenterology and Hepatology, Chinese People's Liberation Army 
      General Hospital, Fuxing Road 28 Haidian District, Beijing, 100853, China.
FAU - Li, Zhenjuan
AU  - Li Z
AD  - Department of Gastroenterology and Hepatology, Chinese People's Liberation Army 
      General Hospital, Fuxing Road 28 Haidian District, Beijing, 100853, China.
FAU - Meng, Jiangyun
AU  - Meng J
AD  - Department of Gastroenterology and Hepatology, Chinese People's Liberation Army 
      General Hospital, Fuxing Road 28 Haidian District, Beijing, 100853, China.
FAU - Tang, Ping
AU  - Tang P
AD  - Department of Gastroenterology and Hepatology, Chinese People's Liberation Army 
      General Hospital, Fuxing Road 28 Haidian District, Beijing, 100853, China.
FAU - Linghu, Enqiang
AU  - Linghu E
AUID- ORCID: 0000-0003-4506-7877
AD  - Department of Gastroenterology and Hepatology, Chinese People's Liberation Army 
      General Hospital, Fuxing Road 28 Haidian District, Beijing, 100853, China. 
      linghuenqiang@vip.sina.com.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20170825
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
MH  - Adult
MH  - Aged
MH  - Endoscopic Mucosal Resection/*methods
MH  - Esophageal Mucosa/*surgery
MH  - Esophageal Neoplasms/*surgery
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Inverted T incision
OT  - Muscularis propria layer
OT  - Submucosal tumor
OT  - Submucosal tunneling endoscopic resection
EDAT- 2017/08/27 06:00
MHDA- 2019/08/03 06:00
CRDT- 2017/08/27 06:00
PHST- 2017/04/29 00:00 [received]
PHST- 2017/07/28 00:00 [accepted]
PHST- 2017/08/27 06:00 [pubmed]
PHST- 2019/08/03 06:00 [medline]
PHST- 2017/08/27 06:00 [entrez]
AID - 10.1007/s00464-017-5800-x [pii]
AID - 10.1007/s00464-017-5800-x [doi]
PST - ppublish
SO  - Surg Endosc. 2018 Mar;32(3):1255-1264. doi: 10.1007/s00464-017-5800-x. Epub 2017 
      Aug 25.