title: Submucosal tunneling endoscopic resection for the treatment of rectal submucosal tumors originating from the muscular propria layer.
abstract: OBJECTIVE
  The objective was to evaluate the clinical value of submucosal tunneling endoscopic resection (STER) for the treatment of submucosal tumors (SMTs) originating from the muscular propria (MP) in the rectum.
  
  
  METHODS
  The clinicopathological data of 12 cases with rectal SMTs originating from the MP layer performed STER in our center from January 2012 to June 2014 were analyzed retrospectively.
  
  
  RESULTS
  Three males and nine females (M/F, 1/3) were studied in this series. The median age of the patients was 53.5 (range, 41-84) years. The tumors located 5-10 cm from the anal verge. En bloc STER was performed successfully in all of the 12 cases. The median size of resected specimens was 1.4 cm (range 1.0-3.0 cm). The median procedure time was 49.5 min (range 40-70 min). Three patients developed low fever after the operation and were all recovered after receiving intravenous antibiotics. One of these three cases developed mucosa perforation, which was closed immediately with metal clips. One patient developed subcutaneous emphysema in one lower limb, which disappeared with conservative treatments 2 weeks after the STER procedure. The median hospital stays were 3.1 (range 2-8) days. Postoperative pathological outcomes revealed schwannoma in 3 cases, leiomyoma in 2 cases, stromal tumor in 5 cases, and proliferation of collagen fibers nodular degeneration in 2 cases. No lesion residual or recurrence was found during postoperative follow-up of 4-33 months.
  
  
  CONCLUSIONS
  STER is a feasible, safe, and effective method for treating SMTs originating from the MP layer in the rectum.
authors.forename: Jian-Wei
authors.initials: JW
authors.lastname: Hu
authors.forename: Chen
authors.initials: C
authors.lastname: Zhang
authors.forename: Tao
authors.initials: T
authors.lastname: Chen
authors.forename: Ping-Hong
authors.initials: PH
authors.lastname: Zhou
authors.forename: Yun-Shi
authors.initials: YS
authors.lastname: Zhong
authors.forename: Yi-Qun
authors.initials: YQ
authors.lastname: Zhang
authors.forename: Wei-Feng
authors.initials: WF
authors.lastname: Chen
authors.forename: Quan-Lin
authors.initials: QL
authors.lastname: Li
authors.forename: Li-Qing
authors.initials: LQ
authors.lastname: Yao
authors.affiliation: Endoscopy Center and Endoscopy Research Institute, Endoscopy Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors.forename: Mei-Dong
authors.initials: MD
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012004:Rectal Neoplasms / Q000601:surgery*