%0 Journal Article
%T Endoscopic Ultrasound-Assisted Tunnel-Type Endoscopic Submucosal Dissection for the Treatment of Esophageal Tumors Arising in the Muscularis Propria(with video)
%A Nan Ge
%A Siyu Sun
%A Sheng Wang
%A Xiang Liu
%A Guoxin Wang
%A Jintao Guo
%J Endoscopic Ultrasound
%@ 2226-7190
%D 2013
%R 10.7178/eus.04.004
%X Objective: Esophageal tumors arising in the muscularis propria are difficult to be resected endoscopically using standard electrosurgicaltechniques, even the endoscopic submucosal dissection (ESD) technique appeared recently. Our purpose is to investigatethe efficacy of endoscopic ultrasound (EUS)-assisted tunnel-type ESD for resection of these tumors.Methods: A total of 17 patients were included in this study. A standard endoscope was used. The submucosal tunnel was createdwith the triangle knife according to the standard ESD technique, about 5 cm proximal to the lesion. EUS was performed within thetunnel to detect the tumor, and then the tumor was separated both from the submucosal and the muscle layers. After the tumor wasremoved, several clips were used to close the mucosal defect. EUS was performed to evaluate the healing quality 1 week after theprocedure.Result: In all the cases, the tumors were completely resected. Mean tumor size was 24.2 mm (12-50 mm) in diameter. The histologicaldiagnoses were leiomyoma (16/17) and gastrointestinal stromal tumor (GIST, 1/17). Subcutaneous emphysema was foundin 2 patients after the procedure, but disappeared by the third day. No patients sustained perforation or developed significant hemorrhage,and there were no other immediate severe complications after the procedure. The healing quality was satisfying in 16/17patients evaluated by EUS 1 week after the procedure. No recurrence has been found during follow-up (mean 7 months, range 3-13months).Conclusion: EUS-assisted tunnel-type ESD is effective and safe in treatment of esophageal tumors arising in the muscularis propria.
%K endoscopic submucosal dissection
%K tunnel-type
%K endoscopic ultrasound
%K submucosal tumor
%K leiomyoma
%K gastrointestinal stromal tumor
%U http://www.eusjournal.com/ch/reader/view_abstract.aspx?file_no=20130104