title: Submucosal tunneling endoscopic resection for upper gastrointestinal submucosal tumors originating from the muscularis propria layer.
abstract: OBJECTIVE
  To estimate the safety and efficacy of submucosal tunneling endoscopic resection (STER) for upper gastrointestinal submucosal tumors (SMTs) originating from the muscularis propria layer.
  
  
  METHODS
  During October 2011 and May 2014, a total of 80 patients with SMTs underwent STER at our hospital. A submucosal tunnel was created from 3-5 cm above the tumor. Endoscopic submucosal dissection of the SMT was performed, and then the mucosal incision was closed with several clips after the tumor was removed.
  
  
  RESULTS
  All the 80 patients underwent STER successfully, with a mean operation time of 61.2 min. Eighty-three SMTs were removed; among these, 67 were located in the esophagus and 16 in the gastric cardia, 68 were leiomyoma, and 15 were gastrointestinal stromal tumors, and 13 had a diameter no less than 35 mm. The mean tumor size was 23.2 mm; en-bloc resection was performed in 97.6% (81/83) of the tumors. Complications were noted in 8.75% (7/80) of the cases, and all of them resolved without the need for additional surgery. No recurrence was noted during a mean follow-up of 10.2 months.
  
  
  CONCLUSIONS
  STER appears to be a feasible, safe, and effective method for upper gastrointestinal SMTs originating from the muscularis propria layer, even when the size of the tumor was larger than 35 mm.
authors.affiliation: Departments of aGeriatrics bGastroenterology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.
authors.forename: Haiqin
authors.initials: H
authors.lastname: Wang
authors.forename: Yuyong
authors.initials: Y
authors.lastname: Tan
authors.forename: Yuqian
authors.initials: Y
authors.lastname: Zhou
authors.forename: Yongjun
authors.initials: Y
authors.lastname: Wang
authors.forename: Chenji
authors.initials: C
authors.lastname: Li
authors.forename: Junfeng
authors.initials: J
authors.lastname: Zhou
authors.forename: Tianying
authors.initials: T
authors.lastname: Duan
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.forename: Deliang
authors.initials: D
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D002299:Cardia / Q000601:surgery; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005773:Gastroscopy / Q000379:methods; D006801:Humans; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000601:surgery; D061646:Operative Time; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome