Current Status and Considerations on Endoscopic Diagnosis and Treatment of Subepithelial Microlesions in the Digestive Tract

Abstract

The detection rate of subepithelial lesions in the digestive tract, especially microlesions (≤ 1 cm in diameter), has significantly increased. Historically, periodic follow-up or surgical resection has been recommended by scholars. Due to the potential risk of malignancy, regular follow-up carries certain risks, while surgical resection, though effective, is highly invasive with a high risk of complications. With the rapid development of endoscopic techniques, more and more subepithelial lesions in the digestive tract have been successfully treated through endoscopic submucosal dissection and endoscopic full-thickness resection. However, these methods require a high level of skill and are associated with significant costs for surgical instruments and materials. Therefore, it is worth exploring whether a simpler and more efficient treatment can transition patients from observation to proactive treatment. A modified technique combining snare, long transparency cap, and Argon Plasma Coagulation under endoscopy has advantages over traditional methods, such as being simpler to perform, less prone to complications, and more cost-effective. This article reviews the current status and considerations of endoscopic treatment for subepithelial lesions in the digestive tract.