Chen SY, Xie ZF, Jiang Y, Lin J, Shi H. Modified endoscopic submucosal tunnel dissection for large esophageal submucosal gland duct adenoma: A case report. World J Gastrointest Surg 2023; 15(5): 1000-1006 [PMID: 37342838 DOI: 10.4240/wjgs.v15.i5.1000]
Corresponding Author of This Article
Hong Shi, MD, Chief Doctor, Department of Endoscopy Center, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420 Fuma Road, Fuzhou 350014, Fujian Province, China. endoshihong@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
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 Gastrointest Surg. May 27, 2023; 15(5): 1000-1006 Published online May 27, 2023. doi: 10.4240/wjgs.v15.i5.1000
Modified endoscopic submucosal tunnel dissection for large esophageal submucosal gland duct adenoma: A case report
Su-Yu Chen, Zhao-Fei Xie, Yan Jiang, Juan Lin, Hong Shi
Su-Yu Chen, Zhao-Fei Xie, Yan Jiang, Juan Lin, Hong Shi, Department of Endoscopy Center, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350014, Fujian Province, China
Author contributions: Chen SY, Xie ZF and Shi H contributed equally to this work. Chen SY, Xie ZF and Shi H were responsible for the study concept and design, including endoscopic procedures; all authors conducted the endoscopic operations together; Chen SY drafted the manuscript; Shi H revised and finalized the manuscript.
Supported byYoung and Middle-aged Mainstay Talent Training Program of Fujian Provincial Health System, China, No. 2017-ZQN-16.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
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: Hong Shi, MD, Chief Doctor, Department of Endoscopy Center, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420 Fuma Road, Fuzhou 350014, Fujian Province, China. endoshihong@126.com
Received: January 16, 2023 Peer-review started: January 16, 2023 First decision: February 1, 2023 Revised: February 20, 2023 Accepted: March 30, 2023 Article in press: March 30, 2023 Published online: May 27, 2023 Processing time: 129 Days and 12.1 Hours
Abstract
BACKGROUND
With the recent improvement of endoscopic techniques, endoscopic ultrasound-guided fine needle aspiration and endoscopic submucosal tunnel dissection (ESTD) have been widely used for accurate diagnosis and dissection acceleration of esophageal tumors.
CASE SUMMARY
We used a modified submucosal tunnel technique during endoscopic en bloc resection in a 58-year-old man with large esophageal submucosal gland duct adenoma (ESGDA). During modified ESTD, the oral end of the involved mucosa was cut transversely, followed by a submucosal tunnel created from the proximal to the distal end, and the anal end of the involved mucosa blocked by the tumor was incised. As a result of retaining submucosal injection solutions using the submucosal tunnel technique, it was possible to reduce the amount of injection required and increase the efficiency and safety of dissection.
CONCLUSION
Modified ESTD is an effective treatment strategy for large ESGDAs. Single-tunnel ESTD appears to be a time-saving procedure compared with conventional endoscopic submucosal dissection.
Core Tip: With the recent improvement of endoscopic techniques, endoscopic ultrasound-guided fine needle aspiration and endoscopic submucosal tunnel dissection (ESTD) have been widely used for accurate diagnosis and dissection acceleration. Here we used a modified submucosal tunnel technique during endoscopic en bloc resection in a 58-year-old man with large esophageal submucosal gland duct adenoma (ESGDA) 3.5 cm × 2.2 cm in size with negative margins. Modified ESTD is an effective treatment strategy for large ESGDAs. Single-tunnel ESTD appears to be a time-saving procedure compared with conventional ESD.
