Lu Q, Peng QZ, Yao J, Wang LS, Li DF. Ligation-assisted endoscopic submucosal resection following unroofing technique for small esophageal subepithelial lesions originating from the muscularis propria. World J Gastroenterol 2024; 30(32): 3748-3754 [DOI: 10.3748/wjg.v30.i32.3748]
Corresponding Author of This Article
De-Feng Li, MD, Department of Gastroenterology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, No. 1017 Dongmen North Road, Luohu District, Shenzhen 518020, Guangdong Province, China.li.defeng@szhospital.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Aug 28, 2024; 30(32): 3748-3754 Published online Aug 28, 2024. doi: 10.3748/wjg.v30.i32.3748
Ligation-assisted endoscopic submucosal resection following unroofing technique for small esophageal subepithelial lesions originating from the muscularis propria
Quan Lu, Quan-Zhou Peng, Jun Yao, Li-Sheng Wang, De-Feng Li
Quan Lu, Jun Yao, Li-Sheng Wang, Department of Gastroenterology, Shenzhen People’s Hospital, Shenzhen 518020, Guangdong Province, China
Quan-Zhou Peng, Department of Pathology, Shenzhen People’s Hospital, Shenzhen 518020, Guangdong Province, China
De-Feng Li, Department of Gastroenterology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, Shenzhen 518020, Guangdong Province, China
De-Feng Li, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen 518020, Guangdong Province, China
Author contributions: Lu Q collected and analyzed the clinical data and drafted the manuscript; Peng QZ provided the histopathological images; Yao J and Wang LS helped revise the manuscript; Li DF provided ideas and comments; All the authors have read and approved the final manuscript.
Supported bythe Engineering Training Funds in Shenzhen, No. SYLY201718, No. SYJY201714, and No. SYLY201801; and Technical Research and Development Project of Shenzhen, No. JCYC20170307100911479, No. JCYJ20190807145617113, and No. JCYJ20210324113802006.
Institutional review board statement: This study was reviewed and approved by Shenzhen People’s Hospital Institutional Review Board.
Informed consent statement: Patients were required to give informed consent to the study. The analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: De-Feng Li, MD, Department of Gastroenterology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, No. 1017 Dongmen North Road, Luohu District, Shenzhen 518020, Guangdong Province, China.li.defeng@szhospital.com
Received: February 25, 2024 Revised: July 19, 2024 Accepted: August 9, 2024 Published online: August 28, 2024 Processing time: 183 Days and 19.1 Hours
Abstract
BACKGROUND
The majority of esophageal subepithelial lesions originating from the muscularis propria (SEL-MPs) are benign in nature, although a subset may exhibit malignant characteristics. Conventional endoscopic resection techniques are time-consuming and lack efficacy for small SEL-MPs.
AIM
To evaluate the efficacy and safety of ligation-assisted endoscopic submucosal resection (ESMR-L) following unroofing technique for small esophageal SEL-MPs.
METHODS
From January 2021 to September 2023, 17 patients diagnosed with esophageal SEL-MPs underwent ESMR-L following unroofing technique at the endoscopy center of Shenzhen People’s Hospital. Details of clinicopathological characteristics and clinical outcomes were collected and analyzed.
RESULTS
The mean age of the patients was 50.12 ± 12.65 years. The mean size of the tumors was 7.47 ± 2.83 mm and all cases achieved en bloc resection successfully. The average operation time was 12.2 minutes without any complications. Histopathology identified 2 Lesions (11.8%) as gastrointestinal stromal tumors at very low risk, 12 Lesions (70.6%) as leiomyoma and 3 Lesions (17.6%) as smooth muscle proliferation. No recurrence was found during the mean follow-up duration of 14.18 ± 9.62 months.
CONCLUSION
ESMR-L following roofing technique is an effective and safe technique for management of esophageal SEL-MPs smaller than 20 mm, but it cannot ensure en bloc resection and may require further treatment.
Core Tip: This is a retrospective study to evaluate the efficacy and safety of ligation-assisted endoscopic submucosal resection following unroofing technique for management of esophageal subepithelial lesions originating from the muscularis propria (SEL-MPs) smaller than 20 mm. The technique has numerous advantages, such as simple operation, complete tumor removal, short operation time, less complications, cost effectiveness, etc. It is an effective and safe technique for management of esophageal SEL-MPs smaller than 20 mm, but it cannot ensure en bloc resection and may require further treatment.
