Submucosal tunneling endoscopic resection: An effective and safe therapy for upper gastrointestinal submucosal tumors originating from the muscularis propria layer

Table 1 Detailed characteristics of the 165 enrolled patients and submucosal tumors n (%)

Outcome	Result (n = 165)
Age, mean ± SD (yr)	46.9 (10.8)
Sex
Men	112 (67.9)
Women	53 (32.1)
Tumor size, median (range, mm)	20.0 (5.0-80.0)
Tumor location
Upper esophagus	11 (6.7)
Middle esophagus	49 (29.7)
Lower esophagus	46 (27.9)
Cardia	59 (35.7)
Tumor shape
Regular	85 (51.5)
Irregular	80 (48.5)
Pathological diagnosis
Leiomyomas	157 (95.2)
GISTs	3 (1.8)
Lipomas	3 (1.8)
Schwannomas	1 (0.6)
Fibrous tumor	1 (0.6)

GISTs: Gastrointestinal stromal tumors.

Table 2 Effectiveness outcomes of submucosal tunneling endoscopic resection for gastrointestinal submucosal tumors n (%)

Characteristic	Result (n = 165)
En bloc resection	128 (77.6)
Complete resection	128 (77.6)
Residual	4 (2.4)
Recurrence	0
Operative time, median (range, min)	46 (10-221)
Hospital time, median (range, d)	7 (4-18)
Length of tunnel, median (range, cm)	7 (5-14)
Clips, median (range)	5 (3-22)
Cost, median (range, USD)	4957.72 (3160.63-12882.63)

Table 3 Safety outcomes of submucosal tunneling endoscopic resection for gastrointestinal submucosal tumors

Complication	Number of patients
Gas-related complications	6
Moderate fever	7
Mucosal injury	10
Chest or abdominal pain	4
Gas-related complications and mucosal injury	1
Gas-related complications and moderate fever	3
Moderate fever and chest pain	1
Moderate fever and pleural effusion	1
Moderate fever and mucosal injury	1
Big perforation of the MP layer	1
Total	35

Table 4 Comparison of baseline characteristics of patients and submucosal tumors between esophagus group and cardia group n (%)

Characteristic	Esophagus group (n = 106)	Cardia group (n = 59)	P-value
Age, mean ± SD (yr)	45.7 (10.5)	48.2 (10.9)	0.053
Sex			0.159
Men	76	36
Women	30	23
Tumor size, median (range, mm)	16.5 (5.0-55.0)	25.0 (6.0-80.0)	0.005a
Tumor shape			0.000a
Regular	66	19
Irregular	40	40
Pathological diagnosis			NA
Leiomyomas	102	55
GISTs	1	2
Lipomas	1	2
Schwannomas	1	0
Fibrous tumor	1	0

^aP < 0.05, there is statistical significance between each other. GISTs: Gastrointestinal stromal tumors; NA: Not available.

Table 5 Comparison of effectiveness outcomes between esophagus group and cardia group n (%)

Characteristic	Esophagus group (n = 106)	Cardia group (n = 59)	P-value
En bloc resection	86 (81.1)	42 (71.2)	0.142
Complete resection	86 (81.1)	42 (71.2)	0.142
Residual	2 (1.9)	2 (3.4)	0.941
Recurrence	0 (0)	0 (0)	NA
Operative time, median (range, min)	46 (12-169)	50 (10-221)	0.232
Hospital time, median (range, d)	7 (4-18)	7 (4-16)	0.261
Clips; median (range)	5 (3-22)	5 (3-16)	0.980
Cost; median (range, USD)	4974.48 (3160.63-12882.63)	4926.60 (3276.43-8718.35)	0.333

NA: Not available.

Table 6 Comparison of safety outcomes between esophagus group and cardia group

Complication	Esophagus group (n = 106)	Cardia group (n = 59)
Gas-related complications	5	1
Moderate fever	5	2
Mucosal injury	3	7
Chest or abdominal pain	3	1
Gas-related complications and mucosal injury	1	0
Gas-related complications and moderate fever	2	1
Moderate fever and chest pain	1	0
Moderate fever and pleural effusion	1	0
Moderate fever and mucosal injury	0	1
Big perforation of the MP layer	0	1
Total	21	14

MP: Muscularis propria.