title: [Submucosal tunneling endoscopic resection in the treatment of esophageal submucosal tumors originating from muscularis propria layer].
abstract: OBJECTIVE
  To evaluate the short-term outcomes and complication management of submucosal tunneling endoscopic resection(STER) for esophageal submucosal tumors (SMTs) originating from the muscularis propria(MP) layer.
  
  
  METHODS
  Clinical data of 48 patients with esophageal SMTs from MP layer undergoing STER in the Department of Gastroenterology, the First People's Hospital of Xiangshan, Zhejiang, and the Endoscopy Center of Zhongshan Hospital, Fudan University, Shanghai between September 2013 and August 2014 were retrospectively analyzed. The clinicopathological features, complication management, and short-term outcomes were evaluated.
  
  
  RESULTS
  All the patients underwent STER successfully. The complete resection rate was 100%. The mean maximum diameter of the lesions was (22.9±12.1) mm (range 9.0-60.0 mm), and the mean operation time 41.8 min (range 15.0-140.0 min). Intraoperative mucosal injury occurred in 5 patients (10.4%), which was successfully clipped, pneumoperitoneum in 2 patients (4.2%) and subcutaneous emphysema in 3 patients(6.3%), which were successfully controlled with conservative treatments. Five patients (10.4%) had postoperative severe chest pain. Seven patients (14.6%) developed fever, among them, 5 were managed by conservative therapy, and 2 were submucosal tunnel infection, who were successfully treated after reclosing the ruptured tunnel entry with clips. All the removed tumors had tumor-free resection margins. The average length of postoperative hospital stay was 2.4 days (range 1-13 days). Local recurrence and distant metastasis did not occur during mean 6.8 months (range 2-12 months) follow up.
  
  
  CONCLUSIONS
  STER appears to be a safe and effective option for esophageal SMTs originating from MP layer. Common complications related to STER often can be successfully controlled with conservative treatments.
authors.affiliation: Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China. zhou.pinghong@zs-hospital.sh.cn.
authors.forename: Haimin
authors.initials: H
authors.lastname: Zhao
authors.forename: Hong
authors.initials: H
authors.lastname: Sheng
authors.forename: Lijiang
authors.initials: L
authors.lastname: Huang
authors.forename: Lingzhi
authors.initials: L
authors.lastname: Jiang
authors.forename: Yunqin
authors.initials: Y
authors.lastname: Xie
authors.forename: Pinghong
authors.initials: P
authors.lastname: Zhou
mesh_terms: D002681:China; D004938:Esophageal Neoplasms; D004945:Esophagoscopy; D006801:Humans; D009092:Mucous Membrane; D009130:Muscle, Smooth; D061646:Operative Time; D012189:Retrospective Studies