Efficacy and safety of piecemeal submucosal tunneling endoscopic resection for giant esophageal leiomyoma

Authors Xin Li; En Liu; Xia Xie; Xue Peng; Xu-Biao Nie; Jian-Jun Li; Yong Gao; Lu Liu; Jian-Ying Bai; Tong-Chuan Wang; Chao-Qiang Fan

doi:10.1016/j.dld.2024.01.193

Efficacy and safety of piecemeal submucosal tunneling endoscopic resection for giant esophageal leiomyoma

Dig Liver Dis. 2024 Feb 5:S1590-8658(24)00223-8. doi: 10.1016/j.dld.2024.01.193. Online ahead of print.

Authors

Authors Xin Li¹, En Liu¹, Xia Xie¹, Xue Peng¹, Xu-Biao Nie¹, Jian-Jun Li¹, Yong Gao¹, Lu Liu¹, Jian-Ying Bai¹, Tong-Chuan Wang², Chao-Qiang Fan³

Affiliations

¹ Institutions Department of Gastroenterology, Xinqiao Hospital, Army Medical University, NO.183, Xinqiao Street, Chongqing, 400037, China.
² Institutions Department of Gastroenterology, Xinqiao Hospital, Army Medical University, NO.183, Xinqiao Street, Chongqing, 400037, China. Electronic address: wangtongchuan001@126.com.
³ Institutions Department of Gastroenterology, Xinqiao Hospital, Army Medical University, NO.183, Xinqiao Street, Chongqing, 400037, China. Electronic address: fcqxhkwjs@126.com.

PMID: 38320913
DOI: 10.1016/j.dld.2024.01.193

Abstract

Background and aims: Giant esophageal leiomyoma usually requires a thoracotomy or thoracoscopic surgery, which is more invasive than an endoscopic treatment. The purpose of this study is to evaluate the efficacy and safety of piecemeal submucosal tunneling endoscopic resection (P-STER) for giant leiomyoma originating from the muscularis propria (MP) layer of the esophagus.

Methods: This is a retrospective study. Patients with giant esophageal leiomyoma (transverse diameter ≥ 3 cm) who underwent P-STER were enrolled from November 2012 to May 2023. Clinical data and results were investigated.

Results: A total of 16 patients were enrolled for analysis. The lesion mean transverse diameter and longitudinal diameter were 4.22 ± 1.20 cm and 6.20 ± 1.57 cm, respectively. Our mean operation time was 195.38 ± 84.99 min. The mean number of piecemeal resected was 4.31 ± 2.36. An adverse event noted was an esophageal fistula that occurred in one case (6.25%) and was treated conservatively. The mean length of hospital stay was around 11.81 ± 7.30 days. The mean total hospitalization cost was U.S. dollars (USD) $5976.50 ± 2866.39. No recurrence or metastasis was found during the follow-up period.

Conclusions: P-STER can be an effective and safe treatment for giant leiomyoma originating from the MP layer of the esophagus.

Keywords: Efficacy and safety; Giant esophageal leiomyoma; Muscularis propria (MP) layer; Piecemeal submucosal tunneling endoscopic resection (P-STER).