title: Retrospective study of endoscopic submucosal tunnel dissection (ESTD) for surgical resection of esophageal leiomyoma.
abstract: BACKGROUND
  Esophageal leiomyoma is benign and often asymptomatic, but if the tumor is too large or obstructive, it should be resected. The aim of this study was to compare a novel approach, endoscopic submucosal tunnel dissection (ESTD), with a more established method, endoscopic submucosal dissection (ESD).
  
  
  METHODS
  This was a retrospective study of 39 patients in Chongqing Xinqiao Hospital, China, undergoing resection for leiomyoma >2 cm in diameter, or 1.5-2.0 cm in diameter with symptoms of obstructive dysphagia. Epidemiological data, presenting symptoms, diagnostic investigations, tumor location, histopathological findings, and safety and efficacy of surgical resection were analyzed.
  
  
  RESULTS
  Mean tumor sizes in the ESTD (n = 18; mean age = 36.7 ± 6.3 years) and ESD (n = 21; age = 41.0 ± 4.4 years) groups were 3.3 ± 0.7 and 3.0 ± 0.4 cm, respectively. The male:female ratio was 25:14, with a distribution of lesions among the lower, middle, and upper esophagus of 22:14:3. Operating time was significantly shorter (p < 0.05) for ESTD (67.5 ± 9.5 min) than for ESD (87.2 ± 7.7 min), while incision healing was faster (p < 0.05) for ESTD (14.7 ± 2.5 days) than for ESD (57.9 ± 7.5 days). Hospital stay was also shorter (p < 0.05) for ESTD (2.3 ± 0.5 days) than for ESD (5.7 ± 1.0 days). Bleeding was the only complication with ESTD (3/18 patients), with no significant difference in the incidence of complications between groups. ESTD was rapidly learned by surgeons.
  
  
  CONCLUSIONS
  ESTD is a safe and effective treatment for esophageal leiomyoma, with advantages over ESD.
authors: Endoscopic Center, Department of Gastroenterology, The Second Hospital of Shandong University, 247 Beiyuan St., Tianqiao, Jinan, 250033, Shandong, China, sciencel122@126.com.
authors: Lei
authors: L
authors: Wang
authors: Wei
authors: W
authors: Ren
authors: Zhimei
authors: Z
authors: Zhang
authors: Jing
authors: J
authors: Yu
authors: Yihui
authors: Y
authors: Li
authors: Yuankun
authors: Y
authors: Song
mesh_terms: D000328:Adult; D002681:China; D004210:Dissection / Q000379:methods*; D016145:Endoscopy, Digestive System / Q000379:methods*; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D009092:Mucous Membrane / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome
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