911 Submucosal Tunneling Endoscopic Resection (STER) for en-bloc Removal of Large Esophageal GIST

2016 ◽  
Vol 83 (5) ◽  
pp. AB183
Author(s):  
Nikhil A. Kumta ◽  
Monica Saumoy ◽  
Amy Tyberg ◽  
Michel Kahaleh
Keyword(s):  
Endoscopic Resection ◽  
En Bloc ◽  
Submucosal Tunneling Endoscopic Resection

scholarly journals Endoscopic submucosal dissection and tunneling procedures using a novel all-in-one bipolar device

2020 ◽  
Vol 08 (10) ◽  
pp. E1302-E1307
Author(s):  
Zaheer Nabi ◽  
Radhika Chavan ◽  
Mohan Ramchandani ◽  
Zacharias Tsiamoulos ◽  
Jahanqeer Basha ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Endoscopic Resection ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Rectal Polyp ◽  
En Bloc ◽  
Epithelial Tumor ◽  
Submucosal Tunneling Endoscopic Resection ◽  
Submucosal Dissection ◽  
Bipolar Device

Abstract Background and study aims Recent innovations in devices and techniques have revolutionized the field of endoscopic resection procedures. In this study, we evaluated the safety and feasibility of endoscopic submucosal dissection and tunneling procedures with a novel, multipurpose bipolar device. Patients and methods Data from consecutive patients who underwent per-oral endoscopic myotomy (POEM), submucosal tunneling endoscopic resection (STER), and endoscopic submucosal dissection (ESD) using a novel bipolar device (December 2019 to February 2020) were analyzed retrospectively. Procedure duration, technical success, and adverse events (AEs) were recorded. Results A total of 10 procedures were performed using the novel bipolar device during the study period. The procedures included POEM (n = 7), STER for esophageal sub-epithelial tumor (n = 1), ESD for rectal polyp (n = 1), and gastric neuroendocrine tumor (n = 1). POEM was successfully completed in all patients. In patients who underwent STER and ESD, en-bloc resection was achieved in all. Mean procedure time for submucosal tunneling procedures (POEM and STER) was 59.12 ± 31.12 minutes. The procedures were completed without the requirement for exchange of accessories in eight cases (80 %). There were no major AEs. Mild and moderate AEs occurred during POEM and included capno-peritoneum (n = 1), retroperitoneal CO2 (n = 1), and empyema (n = 1). Conclusion ESD and tunneling procedures can be safely performed without the need for exchange of accessories using a novel bipolar device. Randomized comparison with conventional knives isrequired to confirm the utility of this device.

Efficacy and complications of submucosal tunneling endoscopic resection for upper gastrointestinal submucosal tumors and exploration for influencing factors

2018 ◽  
Vol 56 (04) ◽  
pp. 365-373 ◽  
Author(s):  
Shunzhe Song ◽  
Xu Wang ◽  
Shen Zhang ◽  
Yanxia Li ◽  
Xiaonan Zhang ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Complete Resection ◽  
Cochrane Library ◽  
En Bloc ◽  
Submucosal Tunneling Endoscopic Resection ◽  
Submucosal Tumors ◽  
Upper Gi ◽  
Upper Gastrointestinal

Abstract Background Submucosal tunneling endoscopic resection (STER) has emerged as a feasible technique for resecting upper gastrointestinal (GI) tract submucosal tumors (SMTs) through natural orifice transluminal endoscopic surgery. STER reduces the risk of postoperative perforation and abdominal infections and promotes rapid wound healing. The aim of this meta-analysis was to evaluate the safety and efficacy of STER for small (≤ 3.5 cm) upper GI SMTs and explore the potential factors influencing STER’s efficacy and complication rate. Methods Comprehensive literature searches were performed to find studies on STER for removal of SMTs. Several English-language databases were searched, including MEDLINE (through PubMed), EMBASE, and the Cochrane Library for the period January 2010 to June 2016. The medical terms “submucosal tunneling endoscopic resection or STER”, “upper gastrointestinal”, and “submucosal tumors” were used in the search. The primary outcome measures were the pooled estimates of the complete resection and en bloc resection rates. The secondary outcome measure was the pooled estimate of complications. Result Twelve studies including 397 patients and 430 lesions were identified. The pooled estimate of the complete resection rate was 98.1 % (95 % confidence interval [CI]: 95.9 – 99.2 %). The pooled estimate of en bloc resection was 94.9 % (95 % CI: 91.1 – 97.1 %). The pooled estimate of gas-related complications such as pneumoperitoneum and subcutaneous emphysema was 21.5 % (95 % CI: 13.2 – 33.1 %). The pooled estimate of inflammation-related complications including pleural and abdominal effusion was 8.4 % (95 % CI: 5.6 – 12.3 %). Gas-related complications occurred more frequently in the esophagogastric junction than in the stomach. In addition, the pooled estimate of delayed bleeding was 2.2 % (95 % CI: 1.0 – 4.7 %). Conclusion STER appeared to be an extremely effective technique for removing upper GI SMTs originating from the muscularis propria layer. In addition, the very low rate of complications also shows the safety of this technique. Tumor size, infiltration depth, and location may influence the complication rates.

scholarly journals Open submucosal tunneling endoscopic resection for special submucosal tumors originating from the muscularis propria

2020 ◽  
Author(s):  
Silin Huang ◽  
Sufang Tu ◽  
Jingwen Fu ◽  
Xiaowei Tang ◽  
Genhua Yang ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
Muscularis Propria ◽  
Operation Time ◽  
Primary Treatment ◽  
En Bloc ◽  
Submucosal Tunneling Endoscopic Resection ◽  
Submucosal Tumors ◽  
Endoscopic Techniques ◽  
The Mean

Abstract Background and Purpose Esophageal submucosal tumors (SMTs) are primarily benign but can have the potential for malignancy. Surgery is the primary treatment; however, the development of endoscopic techniques has promoted the use of endoscopic resection for esophageal SMTs. Submucosal tunneling endoscopic resection (STER) is the current optimal treatment for esophageal SMTs; however, it is challenging to perform in cases of tumors located in the upper esophagus and cardia as well as those with a diameter > 3.5 cm. Based on STER, we proposed and used open STER (O-STER) for special esophageal SMTs. The study aimed to evaluate the safety and efficacy of O-STER for special esophageal SMTs, including those located in the upper esophagus and cardia and those with a diameter > 3.5 cm. Methods The study enrolled 21 patients whose baseline characteristics, clinical data, and follow-up results were retrospectively analyzed. Results A total of 21 lesions were resected. The mean patient age was 44.2 ± 14.4 years. The mean tumor size was 38.2 ± 12.2 mm; 16 (76.2%) tumors had a diameter ≥ 3.5 cm. Tumors were in the cardia in 14 (66.7%) cases and in the upper esophagus in 2 (9.5%) cases. The mean operation time was 56.7 ± 19.3 minutes. The en bloc and complete resection rates were both 100%. There was 1 (4.8%) case of subcutaneous emphysema; no other serious complications were noted. Pathological examinations suggested that most tumors were leiomyomas and had negative margins. During the mean follow-up period of 26.7 months, no cases of residue, recurrence, or metastasis were observed. Conclusions O-STER is a safe and effective treatment for special esophageal SMTs that can reduce operative difficulty and complication rate.

scholarly journals A Nomogram for Predicting Laparoscopic and Endoscopic Cooperative Surgery during the Endoscopic Resection of Subepithelial Tumors of the Upper Gastrointestinal Tract

Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2160
Author(s):  
Shun-Wen Hsiao ◽  
Mei-Wen Chen ◽  
Chia-Wei Yang ◽  
Kuo-Hua Lin ◽  
Yang-Yuan Chen ◽  
...  
Keyword(s):  
Prediction Model ◽  
Endoscopic Resection ◽  
Multivariable Analysis ◽  
Area Under The Curve ◽  
En Bloc ◽  
Discrimination Ability ◽  
Submucosal Tunneling Endoscopic Resection ◽  
Upper Gi ◽  
Upper Gastrointestinal ◽  
Subepithelial Tumors

Background: Considering the widespread use of esophagogastroduodenoscopy, the prevalence of upper gastrointestinal (GI) subepithelial tumors (SET) increases. For relatively safer removal of upper GI SETs, endoscopic submucosal dissection (ESD) has been developed as an alternative to surgery. This study aimed to analyze the outcome of endoscopic resection for SETs and develop a prediction model for the need for laparoscopic and endoscopic cooperative surgery (LECS) during the procedure. Method: We retrospectively analyzed 123 patients who underwent endoscopic resection for upper GI SETs between January 2012 and December 2020 at our institution. Intraoperatively, they underwent ESD or submucosal tunneling endoscopic resection (STER). Results: ESD and STER were performed in 107 and 16 patients, respectively. The median age was 55 years, and the average tumor size was 1.5 cm. En bloc resection was achieved in 114 patients (92.7%). The median follow-up duration was 242 days without recurrence. Perforation occurred in 47 patients (38.2%), and 30 patients (24.4%) underwent LECS. Most perforations occurred in the fundus. Through multivariable analysis, we built a nomogram that can predict LECS requirement according to tumor location, size, patient age, and sex. The prediction model exhibited good discrimination ability, with an area under the curve (AUC) of 0.893. Conclusions: Endoscopic resection is a noninvasive procedure for small upper-GI SETs. Most perforations can be successfully managed endoscopically. The prediction model for LECS requirement is useful in treatment planning.

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