Endoscopic submucosal excavation and submucosal tunneling endoscopic resection of gastroesophageal junction submucosal tumors originating from the muscularis propria layer: a comparative analysis

Abstract

Objective To evaluate the efficacy and safety of endoscopic submucosal excavation(ESE) and submucosal tunneling endoscopic resection (STER) for gastroesophageal junction(GEJ) submucosal tumors (SMTs) originating from the muscularis propria(MP) layer. Methods Clinical data of sixty-one patients with GEJ SMTs originating from the MP layer who were treated with ESE(ESE group, n=39) or STER(STER group, n=22) between January 2013 and December 2015 in Changhai Hospital were retrospectively analyzed. Outcomes and complications in the two groups were compared. Results Single lesion in 61 patients were all resected by therapeutic endoscopy successfully. Operation time in the STER group was shorter than that of the ESE group(47.27±20.89 min VS 66.56±40.07 min, P 0.05]. Hospitalization time of STER group was shorter than that of the ESE group [3.0(1.25)d VS 4.0(1.00)d, P<0.05]. One patient developed delayed hemorrhage in ESE group, while no other complications occurred in either group. The wound healed in both groups under gastroscopy, and no residual or recurrent tumors were detected during the follow-up period. Conclusion Both STER and ESE can be used for GEJ SMTs originating from the MP layer, but STER is more safe and efficient. Key words: Esophageal neoplasms; Endoscopes; Comparative study; Endoscopic submucosal excavation; Submucosal tunneling endoscopic resection