Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 21, 2019; 25(7): 744-776
Published online Feb 21, 2019. doi: 10.3748/wjg.v25.i7.744
Consensus on the digestive endoscopic tunnel technique
Ning-Li Chai, Hui-Kai Li, En-Qiang Linghu, Zhao-Shen Li, Shu-Tian Zhang, Yu Bao, Wei-Gang Chen, Philip WY Chiu, Tong Dang, Wei Gong, Shu-Tang Han, Jian-Yu Hao, Shui-Xiang He, Bing Hu, Bing Hu, Xiao-Jun Huang, Yong-Hui Huang, Zhen-Dong Jin, Mouen A Khashab, James Lau, Peng Li, Rui Li, De-Liang Liu, Hai-Feng Liu, Jun Liu, Xiao-Gang Liu, Zhi-Guo Liu, Ying-Cai Ma, Gui-Yong Peng, Long Rong, Wei-Hong Sha, Pateek Sharma, Jian-Qiu Sheng, Shui-Sheng Shi, Dong Wan Seo, Si-Yu Sun, Gui-Qi Wang, Wen Wang, Qi Wu, Hong Xu, Mei-Dong Xu, Ai-Ming Yang, Fang Yao, Hong-Gang Yu, Ping-Hong Zhou, Bin Zhang, Xiao-Feng Zhang, Ya-Qi Zhai
Ning-Li Chai, Hui-Kai Li, En-Qiang Linghu, Ya-Qi Zhai, Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing 100853, China
Zhao-Shen Li, Zhen-Dong Jin, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
Shu-Tian Zhang, Peng Li, Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Yu Bao, Department of Gastroenterology and Hepatology, Sichuan Cancer Hospital and Institute, Chengdu 610000, Sichuan Province, China
Wei-Gang Chen, Department of Gastroenterology, First Affiliated Hospital of School of Medicine, Shihezi University, Shihezi 832002, Xinjiang Uygur Autonomous Region, China
Philip WY Chiu, Department of Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China
Tong Dang, Department of Gastroenterology, the Second Affiliated Hospital of Baotou Medical College, Baotou 014030, Inner Mongolia Autonomous Region, China
Wei Gong, Department of Gastroenterology, Shenzhen Hospital of Southern Medical University, Shenzhen 518000, Guangdong Province, China
Shu-Tang Han, Gastrointestinal Endoscopy Center, Affiliated Hospital of Nanjing Traditional Chinese Medicine University, Nanjing 210029, Jiangsu Province, China
Jian-Yu Hao, Department of Gastroenterology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
Shui-Xiang He, Department of Gastroenterology, the First Affiliated Hospital of Xi’an Jiao Tong University, Xi’an 710000, Shaanxi Province, China
Bing Hu, Bing Hu, Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Bing Hu, Bing Hu, Department of Endoscopy, Eastern Hepatobiliary Surgical Hospital Affiliated to Naval Medical University, Shanghai 200438, China
Xiao-Jun Huang, Department of Gastroenterology, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu Province, China
Yong-Hui Huang, Department of Gastroenterology, Peking University Third Hospital, Beijing 100191, China
Mouen A Khashab, Division of Gastroenterology and Hepatology, the Johns Hopkins University School of Medicine, Baltimore, MD 21218, United States
James Lau, Department of Gastrointestinal Endoscopy, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China
Rui Li, Department of Gastroenterology, the First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
De-Liang Liu, Department of Gastroenterology, Second Xiangya Hospital of Central South University, Changsha 410000, Hunan Province, China
Hai-Feng Liu, Department of Gastroenterology, General Hospital of Chinese People’s Armed Police Forces, Beijing 100039, China
Jun Liu, Division of Gastroenterology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
Xiao-Gang Liu, Department of Gastroenterology, Sichuan Provincial People’s Hospital, Chengdu 610072, Sichuan Province, China
Zhi-Guo Liu, Department of Gastroenterology, Xijing Hospital, Air Force Medical University, Xi’an 710032, Shaanxi Province, China
Ying-Cai Ma, Department of Digestion, Qinghai Provincial People’s Hospital, Xining 810007, Qinghai Province, China
Gui-Yong Peng, Department of Gastroenterology, Southwest Hospital, Army Medical University, Chongqing 400038, China
Long Rong, Department of Gastroenterology, Peking University First Hospital, Beijing 100034, China
Wei-Hong Sha, Department of Gastroenterology and Hepatology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China
Jian-Qiu Sheng, Department of Gastroenterology, Beijing Military General Hospital, Beijing 100700, China
Shui-Sheng Shi, Endoscopy Center, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
Si-Yu Sun, Endoscopy Center, Shengjing Hospital, China Medical University, Shenyang 110004, Liaoning Province, China
Gui-Qi Wang, Fang Yao, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100020, China
Wen Wang, Department of General Surgery, Fuzhou General Hospital, Fuzhou 350025, Fujian Province, China
Qi Wu, Endoscopy Center, Peking University Cancer Hospital and Institute, Beijing 100142, China
Hong Xu, Endoscopy Center, the First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Mei-Dong Xu, Ping-Hong Zhou, Endoscopy Center, Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Ai-Ming Yang, Department of Gastroenterology, Peking Union Medical College Hospital, Beijing 100730, China
Hong-Gang Yu, Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan University, Wuhan 430060, Hubei Province, China
Bin Zhang, Endoscopy Center, China-Japan Union Hospital of Jilin University, Changchun 130021, Jilin Province, China
Xiao-Feng Zhang, Department of Gastroenterology, Hangzhou First People’s Hospital, Hangzhou 310006, Zhejiang Province, China
Author contributions: Linghu EQ and Chai NL contributed to the conception and design of the paper; Li HK and Zhai YQ did the literature review and analysis; Linghu EQ, Chai NL, Li HK, and Zhai YQ wrote the paper; all members made the critical revision and editing of the article for important intellectual content; all members made the final approval of the final version.
Supported by National Key R and D Program of China, No. 2016YFC1303601.
Conflict-of-interest statement: All authors have no financial relationships to disclose.
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:
Corresponding author: En-Qiang Linghu, MD, PhD, Professor, Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China.
Telephone: +86-10-55499292 Fax: +86-10-68154653
Received: October 14, 2018
Peer-review started: October 15, 2018
First decision: November 1, 2018
Revised: December 19, 2018
Accepted: January 9, 2019
Article in press: January 9, 2019
Published online: February 21, 2019
Core Tip

Core tip: The digestive endoscopic tunnel technique (DETT) makes many diseases that used to be treated by surgery become endoscopically curable by establishing a submucosal tunnel between the mucosa and muscularis propria (MP). At present, the tunnel technique application range covers the treatment of lesions originating from the mucosal and MP layers, and diagnosis and treatment of lesions outside the gastrointestinal tract. However, there is not yet an expert consensus on DETT. In this consensus, we describe the definition, mechanism, and significance of DETT, prevention of infection, methods to establishing a submucosal tunnel, and three main applications of DETT.