Endoscopy 2019; 51(04): S174-S175
DOI: 10.1055/s-0039-1681686
ESGE Days 2019 ePoster podium presentations
Saturday, April 6, 2019 10:30 – 11:00: Third space ePoster Podium 8
Georg Thieme Verlag KG Stuttgart · New York

DOES THIRD-SPACE ENDOSCOPY PROVIDE PROMISING RESULTS FOR THE REMOVAL OF UPPER GASTROINTESTINAL SUBMUCOSAL TUMORS?

F Aslan
1   School of Medicine, Department of Internal Medicine, Koc University, Istanbul, Turkey
,
E Kocak
2   School of Medicine, Koc University, Istanbul, Turkey
,
B Sengun
2   School of Medicine, Koc University, Istanbul, Turkey
,
S Nafiz Karahan
2   School of Medicine, Koc University, Istanbul, Turkey
,
O Yilmaz
2   School of Medicine, Koc University, Istanbul, Turkey
,
O Cig Taskin
3   Department of Pathology, Koc University Hospital, Istanbul, Turkey
,
O Agcaoglu
4   School of Medicine, Department of General Surgery, Koc University, Istanbul, Turkey
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Submucosal-tunneling endoscopic resection (STER) has been a promising technique for treating upper-gastrointestinal submucosal tumors (SMT) originating from the muscularis propria layer. In this study, we aim to present perioperative outcomes of 31 patients with SMTs who underwent STER procedure in a tertiary care center.

Methods:

Between 2015-October and 2018-October, patients who underwent STER for removal of esophageal or gastric SMTs, were analyzed retrospectively from a prospectively kept database. Clinical, pathological and complication data were assessed.

Results:

A total of 42 patients underwent STER and 30 were finally enrolled after excluding the patients who were lost to follow up. Female to male ratio was 11/19 and the mean age was 45.24 (25 – 65). Presenting symptoms included dyspepsia (47.6%), dysphagia (42.9%), and abdominal distention (9.5%).

Mean operative time was 61.7minutes (15 – 180). In terms of localization, 18 (60%) patients had SMTs in esophagus, 3 (10%) in the antrum, 8 (26.7%) in the cardia, and 1 (3.3%) in the corpus. En bloc resection was achieved in all (100%) of the tumors. The mean diameter was 33.3 mm (10 – 82 mm). Histopathological results revealed that 25 (83.3%) patients had leiomyoma, 2 (6.7%) had gastrointestinal stromal tumor, 2 (6.7%) had pancreatic heterotopia, and 1 (3.3%) had granular cell tumor. In terms of perioperative complications, pneumoperitoneum occurred in 2 (6.7%) patients, mucosal laceration occurred in 1 (3.3%) patient and subcutaneous emphysema occurred in 1 (3.3%) patient, all of which are successfully managed without surgery. Mean hospital stay was 2.86days (1 – 5days). No recurrence was observed during a mean follow-up of 25.4months (6 – 30months).

Conclusions:

According to this case series, STER appears to be a safe and effective method considering its low complication rates and favorable outcomes. Patients had a shorter hospital stay compared to surgical procedures and their long-term follow-up results have revealed no recurrence of preoperative complaints or re-emergence of SMTs so far. This study suggests STER can be applied efficaciously for the treatment of SMTs though larger number of cases is needed for further research.