Endoscopic treatment of subepithelial tumors of the esophagus and cardia
https://doi.org/10.24884/1607-4181-2024-31-4-44-54
Abstract
The objective was to evaluate the safety and effectiveness of endoscopic methods for the removal of subepithelial tumors of the esophagus and cardia.
Methods and materials. The study includes 121 patients with subepithelial tumors of the esophagus and cardia, which were removed by endoscopic methods. In order to characterize and study the tumor and determine the correct treatment approach at the diagnostic stage, all patients underwent gastroscopy and endoscopic ultrasonography.
Results. In all cases described above, the tumors have been successfully removed, and no relapses have been noted. The average duration of surgery was 91.49 minutes and it further depended on the size of the tumor. The size of the tumor determines the possibility of removing it as a whole. There are diverticula that form in the area of the removed tumor in some cases, however it is mostly asymptomatic.
Conclusion. Endoscopic methods for the removal of subepithelial tumors are safe, effective and low-traumatic, however, delayed sequela require further study.
About the Authors
A. A. SmirnovRussian Federation
Smirnov Alexander A., Dr. of Sci. (Med.), Associate Professor of the Department of Hospital Surgery № 2 with Clinic, Head of the Endoscopy Department of the Research Institute of Surgery and Emergency Medicine
6-8, L’va Tolstogo str., Saint Petersburg, 197022
Competing Interests:
Authors declare no conflict of interest
Ya. V. Ruchkina
Russian Federation
Ruchkina Yana V., Postgraduate Student of the Department of Hospital Surgery № 2 with Clinic, Endoscopist of the Endoscopy Department № 1 of the Research Institute of Surgery and Emergency Medicine
6-8, L’va Tolstogo str., Saint Petersburg, 197022
Competing Interests:
Authors declare no conflict of interest
M. M. Saadulaeva
Russian Federation
Saadulaeva Marina M., Senior Laboratory Assistant of the Department of Hospital Surgery №2 with Clinic, Endoscopist of the Endoscopy Department № 1 of the Research Institute of Surgery and Emergency Medicine
6-8, L’va Tolstogo str., Saint Petersburg, 197022
Competing Interests:
Authors declare no conflict of interest
E. V. Blinov
Russian Federation
Blinov Egor V., Endoscopist of the Endoscopy Department № 1 of the Research Institute of Surgery and Emergency Medicine
6-8, L’va Tolstogo str., Saint Petersburg, 197022
Competing Interests:
Authors declare no conflict of interest
R. A. Karpova
Russian Federation
Karpova Rimma A., Endoscopist of the Endoscopy Department № 1 of the Research Institute of Surgery and Emergency Medicine
6-8, L’va Tolstogo str., Saint Petersburg, 197022
Competing Interests:
Authors declare no conflict of interest
A. Yu. Korolko
Russian Federation
Korolkov Andrey Yu., Dr. of Sci. (Med.), Professor, Head of the Department of Hospital Surgery № 2 with Clinic, Head of the Department of General and Emergency Surgery of the Research Institute of Surgery and Emergency Medicine
6-8, L’va Tolstogo str., Saint Petersburg, 197022
Competing Interests:
Authors declare no conflict of interest
References
1. Ko W.J., Song G.W., Cho J.Y. Evaluation and endoscopic management of esophageal submucosal tumor // Clin Endosc. 2017;50(3):250‒253. https://doi.org/10.5946/ce.2016.109.
2. Sharzehi K., Sethi A., Savides T. AGA Clinical practice update on management of subepithelial lesions encountered during routine endoscopy: Expert Review // Clin Gastroenterol Hepatol. 2022;20(11):2435‒2443.e4. https://doi.org/10.1016/j.cgh.2022.05.054.
3. Sigal E. I., Burmistrov M. V., Sigal Rom. E., Sigal R. E. Videotoracoscopy in the treatment of benign esophageal submucosal neoplasms // Endoscopic Surgery. 2017;23(1):3‒5. (In Russ.). https://doi.org/10.17116/endoskop20172313-5.
4. Inoue H., Ikeda H., Hosoya T. et al. Submucosal endoscopic tumor resection for subepithelial tumors in the esophagus and cardia // Endoscopy. 2012;44(3):225‒30. https://doi.org/10.1055/s-0031-1291659.
5. Chen T., Zhou P. H., Chu Y. et al. Long-term Outcomes of Submucosal Tunneling Endoscopic Resection for Upper Gastrointestinal Submucosal Tumors// Ann Surg. 2017;265(2):363‒369. https://doi.org/10.1097/SLA.0000000000001650.
6. Liu B. R., Song J. T., Kong L. J. et al. Tunneling endoscopic muscularis dissection for subepithelial tumors originating from the muscularis propria of the esophagus and gastric cardia // Surg Endosc. 2013;27(11):4354‒9. https://doi.org/10.1007/s00464-013-3023-3.
7. Lu J., Lu X., Jiao T., Zheng M. Endoscopic management of upper gastrointestinal submucosal tumors arising from muscularis propria // J Clin Gastroenterol. 2014;48(8):667‒73. https://doi.org/10.1097/MCG.0000000000000135.
8. Drobayzgin E. A., Chikinev Yu. V., Krasilnikov S. E. Submucosal tunneling endoscopic resection of the esophageal and gastroesophageal junction submucosal tumors: a single center study // Russian Journal of Evidence-Based Gastroenterology. 2022;11(4):7‒14. (In Russ.). https://doi.org/10.17116/dokgastro2022110417.
9. Xu J. Q., Xu J. X., Xu X. Y. et al. Landscape of esophageal submucosal tunneling endoscopic resection-related adverse events in a standardized lexicon: a large volume of 1701 cases // Surg Endosc. 2022;36(11):8112‒8120. https://doi.org/10.1007/s00464-022-09241-7.
10. Dzhantukhanova S. V., Starkov Yu. G., Khizrieva N. I. et al. Experience of tunnel operations in the presence of non-epithelial tumors of the esophagus// Endoscopic Surgery. 2023;29(5):35‒46. (In Russ.). https://doi.org/1010.17116/endoskop20232905135.
11. Smirnov A. A., Tkachenko O. B., Burakov A. N. et al. Submucosal tunneling endoscopic resection in the treatment of leiomyomas in the upper third of esophagus // Oncology bulletin of the Volga region. 2017;5(32):28‒32. (In Russ.).
12. Ruchkina Ya. V., Smirnov A. A., Saadulaeva M. M. et al. Experience in endoscopic treatment of cystic formations of the esophagus and mediastinum // The Scientific Notes of the Pavlov University. 2023;30(4):52‒57. (In Russ.). https://doi.org/10.24884/1607-4181-2023-30-4-52-57.
Supplementary files
Review
For citations:
Smirnov A.A., Ruchkina Ya.V., Saadulaeva M.M., Blinov E.V., Karpova R.A., Korolko A.Yu. Endoscopic treatment of subepithelial tumors of the esophagus and cardia. The Scientific Notes of the Pavlov University. 2024;31(4):44-54. (In Russ.) https://doi.org/10.24884/1607-4181-2024-31-4-44-54