Advertisement
Review Article| Volume 33, ISSUE 1, P143-154, January 2023

Submucosal Tunneling Techniques for Tumor Resection

  • Zi-Han Geng
    Affiliations
    Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China

    Shanghai Collaborative Innovation Center of Endoscopy, Shanghai, China
    Search for articles by this author
  • Ping-Hong Zhou
    Affiliations
    Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China

    Shanghai Collaborative Innovation Center of Endoscopy, Shanghai, China
    Search for articles by this author
  • Ming-Yan Cai
    Correspondence
    Corresponding author. Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, 180 FengLin Road, Shanghai 200032, P. R. China.
    Affiliations
    Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China

    Shanghai Collaborative Innovation Center of Endoscopy, Shanghai, China
    Search for articles by this author

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.

      Content published before 2002 is available via pay-per-view purchase only.

      Subscribe:

      Subscribe to Gastrointestinal Endoscopy Clinics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Kalloo A.N.
        • Singh V.K.
        • Jagannath S.B.
        • et al.
        Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity.
        Gastrointest Endosc. 2004; 60: 114-117
        • Sumiyama K.
        • Gostout C.J.
        • Rajan E.
        • et al.
        Submucosal endoscopy with mucosal flap safety valve.
        Gastrointest Endosc. 2007; 65: 688-694
        • Li L.
        • Wang W.
        • Yue H.
        • et al.
        Endoscopic submucosal multi-tunnel dissection for large early esophageal cancer lesions.
        Acta Gastroenterol Belg. 2019; 82: 355-358
        • Gan T.
        • Yang J.L.
        • Zhu L.L.
        • et al.
        Endoscopic submucosal multi-tunnel dissection for circumferential superficial esophageal neoplastic lesions (with videos).
        Gastrointest Endosc. 2016; 84: 143-146
        • Zhai Y.Q.
        • Li H.K.
        • Linghu E.Q.
        Endoscopic submucosal tunnel dissection for large superficial esophageal squamous cell neoplasms.
        World J Gastroenterol. 2016; 22: 435-445
        • Li P.
        • Ma B.
        • Gong S.
        • et al.
        Endoscopic submucosal tunnel dissection for superficial esophageal neoplastic lesions: a meta-analysis.
        Surg Endosc. 2020; 34: 1214-1223
        • Ma L.Y.
        • Liu Z.Q.
        • Yao L.
        • et al.
        Transesophageal endoscopic resection of mediastinal cysts (with video).
        Gastrointest Endosc. 2022; 95: 642-649.e2
        • Ma L.-Y.
        • Liu Z.-Q.
        • Chen W.-F.
        • et al.
        Transgastric Endoscopic Resection of a Superficial Pancreatic Tumor: The First Report in Human Beings.
        Official J Am Coll Gastroenterol ACG. 2022; 117: 373-374
        • Lopes C.V.
        • Hela M.
        • Pesenti C.
        • et al.
        Circumferential endoscopic resection of Barrett's esophagus with high-grade dysplasia or early adenocarcinoma.
        Surg Endosc. 2007; 21: 820-824
        • Giovannini M.
        • Bories E.
        • Pesenti C.
        • et al.
        Circumferential endoscopic mucosal resection in Barrett's esophagus with high-grade intraepithelial neoplasia or mucosal cancer. Preliminary results in 21 patients.
        Endoscopy. 2004; 36: 782-787
        • Chennat J.
        • Konda V.J.
        • Ross A.S.
        • et al.
        Complete Barrett's eradication endoscopic mucosal resection: an effective treatment modality for high-grade dysplasia and intramucosal carcinoma--an American single-center experience.
        Am J Gastroenterol. 2009; 104: 2684-2692
        • Linghu E.
        • Feng X.
        • Wang X.
        • et al.
        Endoscopic submucosal tunnel dissection for large esophageal neoplastic lesions.
        Endoscopy. 2013; 45: 60-62
        • Chai N.L.
        • Li H.K.
        • Linghu E.Q.
        • et al.
        Consensus on the digestive endoscopic tunnel technique.
        World J Gastroenterol. 2019; 25: 744-776
        • Deprez P.H.
        • Moons L.M.G.
        • OʼToole D.
        • et al.
        Endoscopic management of subepithelial lesions including neuroendocrine neoplasms: European Society of Gastrointestinal Endoscopy (ESGE) Guideline.
        Endoscopy. 2022; 54: 412-429
        • Ishihara R.
        • Arima M.
        • Iizuka T.
        • et al.
        Endoscopic submucosal dissection/endoscopic mucosal resection guidelines for esophageal cancer.
        Dig Endosc. 2020; 32: 452-493
        • Xu M.D.
        • Cai M.Y.
        • Zhou P.H.
        • et al.
        Submucosal tunneling endoscopic resection: a new technique for treating upper GI submucosal tumors originating from the muscularis propria layer (with videos).
        Gastrointest Endosc. 2012; 75: 195-199
        • Inoue H.
        • Ikeda H.
        • Hosoya T.
        • et al.
        Submucosal endoscopic tumor resection for subepithelial tumors in the esophagus and cardia.
        Endoscopy. 2012; 44: 225-230
        • Li Q.-L.
        • Yao L.-Q.
        • Zhou P.-H.
        • et al.
        Submucosal tumors of the esophagogastric junction originating from the muscularis propria layer: a large study of endoscopic submucosal dissection (with video).
        Gastrointest Endosc. 2012; 75: 1153-1158
        • Liu B.R.
        • Song J.T.
        Submucosal Tunneling Endoscopic Resection (STER) and Other Novel Applications of Submucosal Tunneling in Humans.
        Gastrointest Endosc Clin N Am. 2016; 26: 271-282
        • Chen T.
        • Lin Z.W.
        • Zhang Y.Q.
        • et al.
        Submucosal Tunneling Endoscopic Resection vs Thoracoscopic Enucleation for Large Submucosal Tumors in the Esophagus and the Esophagogastric Junction.
        J Am Coll Surg. 2017; 225: 806-816
        • Li Q.Y.
        • Meng Y.
        • Xu Y.Y.
        • et al.
        Comparison of endoscopic submucosal tunneling dissection and thoracoscopic enucleation for the treatment of esophageal submucosal tumors.
        Gastrointest Endosc. 2017; 86: 485-491
        • Liu B.R.
        • Song J.T.
        • Kong L.J.
        • et al.
        Tunneling endoscopic muscularis dissection for subepithelial tumors originating from the muscularis propria of the esophagus and gastric cardia.
        Surg Endosc. 2013; 27: 4354-4359
        • Chen T.
        • Zhou P.H.
        • Chu Y.
        • et al.
        Long-term Outcomes of Submucosal Tunneling Endoscopic Resection for Upper Gastrointestinal Submucosal Tumors.
        Ann Surg. 2017; 265: 363-369
        • Wang H.
        • Tan Y.
        • Zhou Y.
        • et al.
        Submucosal tunneling endoscopic resection for upper gastrointestinal submucosal tumors originating from the muscularis propria layer.
        Eur J Gastroenterol Hepatol. 2015; 27: 776-780
        • Lu J.
        • Jiao T.
        • Zheng M.
        • et al.
        Endoscopic resection of submucosal tumors in muscularis propria: the choice between direct excavation and tunneling resection.
        Surg Endosc. 2014; 28: 3401-3407
        • Tan Y.
        • Zhou B.
        • Zhang S.
        • et al.
        Submucosal Tunneling Endoscopic Resection for Gastric Submucosal Tumors: a Comparison Between Cardia and Non-cardia Location.
        J Gastrointest Surg. 2019; 23: 2129-2135
        • Rajan E.
        • Kee W.
        • Song L.M.
        Endoscopic Full Thickness Resection.
        Gastroenterology. 2018; 154: 1925-1937.e2
        • Li Q.L.
        • Chen W.F.
        • Zhang C.
        • et al.
        Clinical impact of submucosal tunneling endoscopic resection for the treatment of gastric submucosal tumors originating from the muscularis propria layer (with video).
        Surg Endosc. 2015; 29: 3640-3646
        • Ye L.P.
        • Zhang Y.
        • Mao X.L.
        • et al.
        Submucosal tunneling endoscopic resection for small upper gastrointestinal subepithelial tumors originating from the muscularis propria layer.
        Surg Endosc. 2014; 28: 524-530
        • Geng Z.-H.
        • Zhu Y.
        • Chen W.-F.
        • et al.
        A scoring system to support surgical decision-making for cardial submucosal tumors.
        Endosc Int Open. 2022; 10: E468-E478
        • Turner B.G.
        • Gee D.W.
        • Cizginer S.
        • et al.
        Endoscopic transesophageal mediastinal lymph node dissection and en bloc resection by using mediastinal and thoracic approaches (with video).
        Gastrointest Endosc. 2010; 72: 831-835
        • Cai M.Y.
        • Zhu B.Q.
        • Xu M.D.
        • et al.
        Submucosal tunnel endoscopic resection for extraluminal tumors: a novel endoscopic method for en bloc resection of predominant extraluminal growing subepithelial tumors or extra-gastrointestinal tumors (with videos).
        Gastrointest Endosc. 2018; 88: 160-167
        • Liu X.
        • Chen T.
        • Cheng J.
        • et al.
        Endoscopic transmural route for dissection of gastric submucosal tumors with extraluminal growth: experience in two cases.
        Gut. 2021; 70: 2052-2054
        • Gao P.
        • Li Q.
        • Hu J.
        • et al.
        Transoesophageal endoscopic removal of a benign mediastinal tumour: a new field for endotherapy?.
        Gut. 2020; 69: 1727-1729
        • Wen J.
        • Lu Z.
        • Yang Y.
        • et al.
        Preventing stricture formation by covered esophageal stent placement after endoscopic submucosal dissection for early esophageal cancer.
        Dig Dis Sci. 2014; 59: 658-663
        • Pih G.Y.
        • Kim D.H.
        • Gong E.J.
        • et al.
        Preventing esophageal strictures with steroids after endoscopic submucosal dissection in superficial esophageal neoplasm.
        J Dig Dis. 2019; 20: 609-616
        • Cai M.
        • Chen J.
        • Zhou P.
        • et al.
        The rise of tunnel endoscopic surgery: a case report and literature review.
        Case Rep Gastrointest Med. 2012; 2012: 847640
        • Ponsaing L.G.
        • Kiss K.
        • Hansen M.B.
        Classification of submucosal tumors in the gastrointestinal tract.
        World J Gastroenterol. 2007; 13: 3311-3315
        • Tsai S.J.
        • Lin C.C.
        • Chang C.W.
        • et al.
        Benign esophageal lesions: endoscopic and pathologic features.
        World J Gastroenterol. 2015; 21: 1091-1098
        • Demetri G.D.
        • von Mehren M.
        • Antonescu C.R.
        • et al.
        NCCN Task Force report: update on the management of patients with gastrointestinal stromal tumors.
        J Natl Compr Canc Netw. 2010; 8 ([quiz:S2-S4]): S1-S41
        • Kulke M.H.
        • Anthony L.B.
        • Bushnell D.L.
        • et al.
        NANETS treatment guidelines: well-differentiated neuroendocrine tumors of the stomach and pancreas.
        Pancreas. 2010; 39: 735-752
        • Nishida T.
        • Blay J.Y.
        • Hirota S.
        • et al.
        The standard diagnosis, treatment, and follow-up of gastrointestinal stromal tumors based on guidelines.
        Gastric Cancer. 2016; 19: 3-14
        • Lv X.H.
        • Wang C.H.
        • Xie Y.
        Efficacy and safety of submucosal tunneling endoscopic resection for upper gastrointestinal submucosal tumors: a systematic review and meta-analysis.
        Surg Endosc. 2017; 31: 49-63
        • Li Z.
        • Gao Y.
        • Chai N.
        • et al.
        Effect of submucosal tunneling endoscopic resection for submucosal tumors at esophagogastric junction and risk factors for failure of en bloc resection.
        Surg Endosc. 2018; 32: 1326-1335
        • Rahman S.A.
        • Walker R.C.
        • Lloyd M.A.
        • et al.
        Machine learning to predict early recurrence after oesophageal cancer surgery.
        Br J Surg. 2020; 107: 1042-1052
        • Aslanian H.R.
        • Sethi A.
        • Bhutani M.S.
        • et al.
        ASGE guideline for endoscopic full-thickness resection and submucosal tunnel endoscopic resection.
        VideoGIE. 2019; 4: 343-350
        • Zhang M.
        • Wu S.
        • Xu H.
        Comparison Between Submucosal Tunneling Endoscopic Resection (STER) and Other Resection Modules for Esophageal Muscularis Propria Tumors: A Retrospective Study.
        Med Sci Monit. 2019; 25: 4560-4568
        • Du C.
        • Linghu E.
        Submucosal Tunneling Endoscopic Resection for the Treatment of Gastrointestinal Submucosal Tumors Originating from the Muscularis Propria Layer.
        J Gastrointest Surg. 2017; 21: 2100-2109
        • Du C.
        • Chai N.L.
        • Ling-Hu E.Q.
        • et al.
        Submucosal tunneling endoscopic resection: An effective and safe therapy for upper gastrointestinal submucosal tumors originating from the muscularis propria layer.
        World J Gastroenterol. 2019; 25: 245-257
        • Chen T.
        • Zhang C.
        • Yao L.Q.
        • et al.
        Management of the complications of submucosal tunneling endoscopic resection for upper gastrointestinal submucosal tumors.
        Endoscopy. 2016; 48: 149-155
        • So S.
        • Ahn J.Y.
        • Kim N.
        • et al.
        Comparison of the effects of antithrombotic therapy on delayed bleeding after gastric endoscopic resection: a propensity score-matched case-control study.
        Gastrointest Endosc. 2019; 89 (e2): 277-285
        • Mukai S.
        • Cho S.
        • Kotachi T.
        • et al.
        Analysis of delayed bleeding after endoscopic submucosal dissection for gastric epithelial neoplasms.
        Gastroenterol Res Pract. 2012; 2012: 875323
        • Lu J.
        • Jiao T.
        • Li Y.
        • et al.
        Heading toward the right direction--solution package for endoscopic submucosal tunneling resection in the stomach.
        PLoS One. 2015; 10: e0119870
        • Lu J.
        • Zheng M.
        • Jiao T.
        • et al.
        Transcardiac tunneling technique for endoscopic submucosal dissection of gastric fundus tumors arising from the muscularis propria.
        Endoscopy. 2014; 46: 888-892
        • Zhu L.L.
        • Wu J.C.
        • Wang Y.P.
        • et al.
        Endoscopic Submucosal Single- or Multi-tunnel Dissection for Near-Circumferential and Circumferential Superficial Esophageal Neoplastic Lesions.
        Gastroenterol Res Pract. 2019; 2019: 2943232
        • Oliveira J.F.
        • Moura E.G.
        • Bernardo W.M.
        • et al.
        Prevention of esophageal stricture after endoscopic submucosal dissection: a systematic review and meta-analysis.
        Surg Endosc. 2016; 30: 2779-2791
        • Liu L.
        • Guo H.M.
        • Miao F.
        • et al.
        Endoscopic Esophageal Submucosal Tunnel Dissection for Cystic Lesions Originating from the Muscularis Propria of the Gastric Cardia.
        J Oncol. 2020; 2020: 5259717
        • Mao X.L.
        • Ye L.P.
        • Zheng H.H.
        • et al.
        Submucosal tunneling endoscopic resection using methylene-blue guidance for cardial subepithelial tumors originating from the muscularis propria layer.
        Dis Esophagus. 2017; 30: 1-7
        • Wu B.H.
        • Shi R.Y.
        • Zhang H.Y.
        • et al.
        Feasibility and Safety of Mark-Guided Submucosal Tunneling Endoscopic Resection for Treatment of Esophageal Submucosal Tumors Originating from the Muscularis Propria: A Single-Center Retrospective Study.
        Can J Gastroenterol Hepatol. 2021; 2021: 9916927
        • Wang G.X.
        • Yu G.
        • Xiang Y.L.
        • et al.
        Submucosal tunneling endoscopic resection for large symptomatic submucosal tumors of the esophagus: A clinical analysis of 24 cases.
        Turk J Gastroenterol. 2020; 31: 42-48
        • Hu J.W.
        • Zhang C.
        • Chen T.
        • et al.
        Submucosal tunneling endoscopic resection for the treatment of rectal submucosal tumors originating from the muscular propria layer.
        J Cancer Res Ther. 2014; 10: 281-286