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Background and Aims <p>Submucosal tunneling endoscopic resection (STER) is an&#xa0;effective and safe treatment for esophageal submucosal tumors (SMTs) with small sizes, yet its efficacy for multiple SMTs remains unclear. This study aimed to evaluate the feasibility and safety of STER in one tunnel for multiple esophageal SMTs originating from the muscularis propria layer.</p> Methods <p>Between June 2012 and December 2024, patients with multiple esophageal SMTs who underwent STER were included in this study. Data on patient characteristics, ‌clinical‌ outcomes, and follow-up ‌were retrospectively analyzed.</p> Results <p>STER was performed in 72 patients (43 male, median age 55&#xa0;years) with 158 SMTs. The median lesion size of each patient was 1.9&#xa0;cm (range 0.5–3.5). The rate of en bloc resection was&#xa0;89.2%. Postoperative adverse events (AEs) included pneumothorax/hydrothorax (5 cases), mucosal injury (5 cases), and pneumonia (1 case). The procedure time was significantly shorter for patients with two tumors than for those with more than two tumors (41&#xa0;min vs.54&#xa0;min, <i>P</i> = 0.029). No significant differences were found between patients with two tumors and those with &gt; 2 tumors in terms of tunnel length, hospital stay, and AEs (all <i>P</i> &gt; 0.05). No local recurrence or distant metastasis occurred during a median follow-up of 71&#xa0;months.</p> Conclusion <p>One-tunnel STER is an effective and safe treatment for multiple esophageal SMTs originating from the muscularis propria layer, particularly when performed by experienced endoscopists. Long-term surveillance remains crucial for early detection of recurrence.</p>

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Feasibility and Safety of Submucosal Tunneling Endoscopic Resection in One Tunnel for Multiple Esophageal Submucosal Tumors Originating from the Muscularis Propria Layer

  • 期刊论文

  • 发表日期：

    2025年11月5日

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  • Shao-Bin Luo,
  • Zu-Qiang Liu,
  • Li Wang,
  • Yi-Qun Zhang,
  • Ming-Yan Cai,
  • Quan-Lin Li,
  • Ping-Hong Zhou

摘要

Background and Aims

Submucosal tunneling endoscopic resection (STER) is an effective and safe treatment for esophageal submucosal tumors (SMTs) with small sizes, yet its efficacy for multiple SMTs remains unclear. This study aimed to evaluate the feasibility and safety of STER in one tunnel for multiple esophageal SMTs originating from the muscularis propria layer.

Methods

Between June 2012 and December 2024, patients with multiple esophageal SMTs who underwent STER were included in this study. Data on patient characteristics, ‌clinical‌ outcomes, and follow-up ‌were retrospectively analyzed.

Results

STER was performed in 72 patients (43 male, median age 55 years) with 158 SMTs. The median lesion size of each patient was 1.9 cm (range 0.5–3.5). The rate of en bloc resection was 89.2%. Postoperative adverse events (AEs) included pneumothorax/hydrothorax (5 cases), mucosal injury (5 cases), and pneumonia (1 case). The procedure time was significantly shorter for patients with two tumors than for those with more than two tumors (41 min vs.54 min, P = 0.029). No significant differences were found between patients with two tumors and those with > 2 tumors in terms of tunnel length, hospital stay, and AEs (all P > 0.05). No local recurrence or distant metastasis occurred during a median follow-up of 71 months.

Conclusion

One-tunnel STER is an effective and safe treatment for multiple esophageal SMTs originating from the muscularis propria layer, particularly when performed by experienced endoscopists. Long-term surveillance remains crucial for early detection of recurrence.