Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2015; 21(10): 2982-2987
Published online Mar 14, 2015. doi: 10.3748/wjg.v21.i10.2982
Endoscopic resection using band ligation for esophageal SMT in less than 10 mm
Joung Boom Hong, Cheol Woong Choi, Hyung Wook Kim, Dae Hwan Kang, Su Bum Park, Su Jin Kim, Dong Jun Kim
Joung Boom Hong, Cheol Woong Choi, Hyung Wook Kim, Dae Hwan Kang, Su Bum Park, Su Jin Kim, Dong Jun Kim, Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Gyeongsangnam-do 626-770, South Korea
Author contributions: Choi CW designed research; Choi CW and Kim HW performed research; Kang DH, Park SB, Kim SJ and Kim DJ collected data; Hong JB analyzed data and wrote the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Cheol Woong Choi, PhD, MD, Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomeori, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do 626-770, South Korea. luckyace@hanmail.net
Telephone: +82-55-3601535 Fax: +82-55-3601536
Received: August 25, 2014
Peer-review started: August 26, 2014
First decision: September 15, 2014
Revised: October 11, 2014
Accepted: November 30, 2014
Article in press: December 1, 2014
Published online: March 14, 2015
Abstract

AIM: To evaluate the safety and feasibility of endoscopic resection using band ligation (EMR-B) for the diagnostic and therapeutic removal of tumors located in the esophageal subepithelial region having originated from the submucosa.

METHODS: From May 2009 to September 2014, after medical chart and endoscopic ultrasonography report review, a total of 15 esophageal tumors located in the submucosal layer were resected by EMR-B. Previous symptom, location, pathology, complete resection rate, incidence of complications, incidence of minor complication, size, length of procedures time and follow up months were evaluated. To evaluate local recurrence at the resection site, periodic follow-up endoscopic examination was undertaken in all of the patients. The first endoscopic examination was performed about 6 mo after the endoscopic resection. Thereafter, the endoscopic follow up were scheduled annually.

RESULTS: The mean age was 50.3 ± 9.67 years. The mean tumor size was 6.93 ± 3.15 mm and most of the lesions size was between 5-10 mm in diameter (10/15, 66.6%). In all patients, endoscopic en bloc resection was achieved. In one patient, the vertical margin was involved. The mean procedural time was 8.86 ± 3.66 min. In all patients, no evidence of severe complications such as perforation or bleeding occurred. Minor complications such as chest pain (2/15, 13.3%) and heartburn (3/15, 13.3%) were reported but they symptoms were controlled by proton pump inhibitors, ulcermin and/or analgesics. Histologic assessments of the removed specimens revealed 10 granular cell tumors (66.6%), 4 leiomyomas (16.6%) and one lipoma (6.6%). No recurrence was observed during the mean follow up period of 45 ± 3.5 mo (range: 5-64 mo).

CONCLUSION: EMR-B might be considered safe and effective for the diagnosis and treatment of lesions measuring less than 10 mm in diameter.

Keywords: Band ligation, Endoscopic mucosal resection, Esophagus, Submucosal tumor, Ultrasonography

Core tip: In cases of esophageal tumors originating in the submucosal layer, we consider that endoscopic resection may be necessary if esophageal biopsy results are non-conclusive. Endoscopic resection using band ligation is effective for diagnosis and treatment of lesions measuring less than 10 mm in diameter.