Pathological features of esophageal submucosal tumors and curative effects of endoscopic resection / 西安交通大学学报(医学版)

ABSTRACT

Objective: To analyze the clinicopathological and biological characteristics of esophageal submucosal tumors (SMTs) and to investigate the safety and efficacy of endoscopic resection for esophageal SMTs. Methods: We retrospectively analyzed the data of 152 cases of esophageal submucosal tumors resected by endoscopy in Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, from February 2013 to June 2018 as well as the pathological properties, distribution characteristics, origin and location of the esophageal SMTs. We also analyzed complications and efficacy of different methods for endoscopic resection. Results: The average age of onset of esophageal SMTs in this group was 52.74±10.53 years, without gender difference. Pathological features were as follows leiomyoma was more common (73.68%), followed by stromal tumor (11.18%), hemangioma (3.95%), cyst (3.29%), and lipoma (1.97%). SMTs occurred mostly in the middle and lower segments of the esophagus. They were mainly located in the muscularis mucosa (31.58%) and muscularis propria (57.89%), and partly located in the submucosa (10.53%). Endoscopic resection methods consisted of endoscopic mucosal resection (EMR) performed in 36 cases, endoscopic submucosal dissection (ESD) in 52 cases, submucosal tunneling endoscopic resection (STER) in 63 cases, and full-thickness resection (EFTR) in 1 case. All lesions were completely resected. EMR had small tumor resection and shorter operative time; ESD and STER showed large tumor resection and long operation time (P0.05). Complications were effectively controlled. No local recurrence or residual cases were found in postoperative follow-up. Conclusion: Adult onset of submucosal tumors of the esophagus, without gender difference, can occur in all segments of the esophagus, mostly from the mucosal muscularis and muscularis propria. Leiomyoma is common, followed by stromal tumor, spindle cell tumor, and hemangioma. Endoscopic resection depends on the lesion location, source and size, and endoscopic treatment is safe and effective.