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En bloc submucosal tunneling endoscopic resection for a giant esophageal leiomyoma
VideoGIE
En bloc submucosal tunneling endoscopic resection for a giant esophageal leiomyoma
Figure 1. A, Submucosal tumor located in the esophagus. B, The lesion within the tunnel after dissection off the MP layer. C, A large empty tunnel after retrieval of the tumor. D, The resected tumor.
Submucosal tunneling endoscopic resection (STER) has been proved to be safe and effective for removal of upper GI tumors originating from the muscularis propria (MP). However, most researchers recommended a maximum resectable lesion size of 40 mm because of the limited space of the submucosal tunnel. Tumor fragmentation or conversion to surgery was needed when the tumor was larger than 5 cm. In this video, we demonstrate the feasibility of en bloc resection of STER for a giant esophageal leiomyoma. A 41year-old man was seen with a 3-month history of dysphagia. Chest CT revealed a 5.2 3.0 2.2 cm esophageal mass
adjacent to the aortic arch. A submucosal tunnel was created and extended 2 cm distal to the lesion. The leiomyoma was then carefully dissected off the MP layer and was successfully extracted from the tunnel en bloc. The mucosal entry was closed with several clips (Fig. 1; Video 1, available online at www.giejournal.org). The patient was discharged 7 days after STER without any adverse events, and the tumor was diagnosed histologically as leiomyoma. We demonstrated that STER is technically feasible and safe in expert hands, and removal of larger lesions may be possible. DISCLOSURE
This video can be viewed directly from the GIE website or by using the QR code and your mobile device. Download a free QR code scanner by searching “QR Scanner” in your mobile device’s app store.
www.giejournal.org
All authors disclosed no financial relationships relevant to this publication. Yuyong Tan, MD, Deliang Liu, MD, PhD, Department of Gastroenterology, The Second XiangYa Hospital of Central South University, Changsha, Hunan, China http://dx.doi.org/10.1016/j.gie.2015.03.1904
Volume 82, No. 2 : 2015 GASTROINTESTINAL ENDOSCOPY 399
En bloc submucosal tunneling endoscopic resection for a giant esophageal leiomyoma
Figure 1. A, Submucosal tumor located in the esophagus. B, The lesion within the tunnel after dissection off the MP layer. C, A large empty tunnel after retrieval of the tumor. D, The resected tumor.
Submucosal tunneling endoscopic resection (STER) has been proved to be safe and effective for removal of upper GI tumors originating from the muscularis propria (MP). However, most researchers recommended a maximum resectable lesion size of 40 mm because of the limited space of the submucosal tunnel. Tumor fragmentation or conversion to surgery was needed when the tumor was larger than 5 cm. In this video, we demonstrate the feasibility of en bloc resection of STER for a giant esophageal leiomyoma. A 41year-old man was seen with a 3-month history of dysphagia. Chest CT revealed a 5.2 3.0 2.2 cm esophageal mass
adjacent to the aortic arch. A submucosal tunnel was created and extended 2 cm distal to the lesion. The leiomyoma was then carefully dissected off the MP layer and was successfully extracted from the tunnel en bloc. The mucosal entry was closed with several clips (Fig. 1; Video 1, available online at www.giejournal.org). The patient was discharged 7 days after STER without any adverse events, and the tumor was diagnosed histologically as leiomyoma. We demonstrated that STER is technically feasible and safe in expert hands, and removal of larger lesions may be possible. DISCLOSURE
This video can be viewed directly from the GIE website or by using the QR code and your mobile device. Download a free QR code scanner by searching “QR Scanner” in your mobile device’s app store.
www.giejournal.org
All authors disclosed no financial relationships relevant to this publication. Yuyong Tan, MD, Deliang Liu, MD, PhD, Department of Gastroenterology, The Second XiangYa Hospital of Central South University, Changsha, Hunan, China http://dx.doi.org/10.1016/j.gie.2015.03.1904
Volume 82, No. 2 : 2015 GASTROINTESTINAL ENDOSCOPY 399