Submucosal tunneling endoscopic resection: An effective and safe therapy for upper gastrointestinal submucosal tumors originating from the muscularis propria layer

Figure 1 Study flowchart.

Figure 2 Submucosal tunneling endoscopic resection for a submucosal tumor originating from the muscularis propria layer in the esophagus. A: Endoscopic view of a submucosal tumor (SMT) in the esophagus; B: Endoscopic ultrasound view of the same SMT, showing that lesion originates from the muscularis propria (MP) layer; C: Submucosal injection at 5 cm proximal to the SMT; D: An inverted T mucosal incision; E: Establishment of a submucosal tunnel between the mucosal and MP layers; F: Exposure of the SMT; G: The tunnel after the resection of the tumor; H: Closure of the mucosal incision site with clips; I: The resected specimen.

Figure 3 Submucosal tunneling endoscopic resection for a submucosal tumor originating from the muscularis propria layer in the cardia. A: Endoscopic view of a submucosal tumor (SMT) in the cardia; B: Endoscopic ultrasound view of the same SMT; C: Submucosal injection at 5 cm proximal to the SMT; D: A longitudinal mucosal incision; E: Establishment of a submucosal tunnel between the mucosal and muscularis propria layers; F: Exposure of the SMT; G: The tunnel after the resection of the tumor; H: Closure of the mucosal incision site with clips; I: The resected specimen.