Modified submucosal tunneling endoscopic resection for postcricoid esophageal subepithelial tumor
Submucosal tunneling endoscopic resection (STER) has been described as a technique for endoscopic resection of GI subepithelial tumors (SETs) arising from the muscularis propria layer1 and is an accepted treatment modality for these SETs.2 The standard STER technique involves submucosal elevation 3 to 5 cm proximal to the SET along its longitudinal axis, mucosotomy, submucosal tunneling, dissection of the SET within the tunnel, enucleation from the deep muscle layer, and specimen delivery followed by mucosal closure.2 STER is usually recommended for SETs 3.5 cm) or for lesions in challenging locations is technically difficult; thus, surgical resection is usually recommended.2, 3, 4 STER has demonstrated excellent outcomes in a recent large meta-analysis.5 Postcricoid (PC) SETs can present exceptional technical challenges for STER because of their proximal location and constrained space in this region for tunneling and endoscope maneuverability. We report a video case of successful PC STER using certain technical modifications.
Bapaye, J. A., Gandhi, A., Pittanyanon, R., Kongkam, P., & Bapaye, A. (2022). Modified submucosal tunneling endoscopic resection for postcricoid esophageal subepithelial tumor. VideoGIE, 7 (3), 91-94. https://doi.org/10.1016/j.vgie.2021.12.008