Effects analysis of endoscopic submucosal tunnel dissection in treatment of upper gastrointestinal tumor

Abstract

Objective Endoscopic submucosal tunnel resection (ESTD) is defined as the endoscopic operation finished in the tunnel established between the mucosa and muscle layer in the digestive tract. The purpose of this paper is to evaluate the application of ESTD in the upper gastrointestinal tumor resection. Methods Eligible clinical reports about ESTD for the treatment of upper gastrointestinal tumors were identified from the database (2007-2014). The operation techniques, clinical application and complications were systematically analyzed. Results A total of 16 studies involving 196 cases (33 with malignant lesions, 163 benign) were included. The longest diameters of most tumors were less than 3 cm. The complete resection rate and whole block excision rate were close to 100%. Perforation was one of the common complications. The incidences of intraoperative perforation fluctuated between 0 and 100%, depending on the tumor size, tumor location, etc. However, there was no postoperative continuous gastrointestinal perforation. Serious complications such as peripheral viscera injury, bleeding, severe mediastinum infection were not reported in the studies. Conclusions ESTD is an effective, safe and minimally invasive surgical technique in the resection of upper gastrointestinal submucosal benign lesions. It may yield similar outcome with surgical treatment when the longest diameter is less than 3 cm. Key words: Endoscopy; Submucosal tunneling technique; Endoscopic submucosal tunnel dissection; Upper gastrointestinal tract; Submucosal tumors; Precancerous lesions; Carcinoma in situ