Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, China.
J Gastrointest Surg. 2017 Dec;21(12):2100-2109. doi: 10.1007/s11605-017-3579-7. Epub 2017 Oct 17.
Surgical resection and endoscopic resection comprise two alternative options for the treatment of submucosal tumors (SMTs) originating from the muscularis propria (MP) layer. Endoscopic resection is minimally invasive compared with surgical resection. Conventional non-tunneling techniques, such as endoscopic submucosal dissection (ESD), endoscopic submucosal excavation (ESE), and endoscopic full-thickness resection (EFR) have been demonstrated to be safe and effective. However, these techniques fail to maintain the integrity of the mucosa and induce high risk of perforation, infection, and postoperative strictures. Submucosal tunneling endoscopic resection (STER) is a novel surgical technique that can maintain the integrity of the mucosa by establishing a tunnel between the submucosal and the MP layers. STER has been proven to be effective and safe for the treatment of SMTs. Currently, STER has become a standard treatment for gastrointestinal (GI) SMTs originating from the MP layer, notably in China. In the present review, we describe the indications, procedures, postoperative care, efficacy and safety outcomes, and future perspectives of STER for GI SMTs originating from the MP layer.
手术切除和内镜切除是治疗起源于固有肌层 (MP) 的黏膜下肿瘤 (SMT) 的两种替代选择。与手术切除相比,内镜切除具有微创性。传统的非隧道技术,如内镜黏膜下剥离术 (ESD)、内镜黏膜下挖除术 (ESE) 和内镜全层切除术 (EFR) 已被证明是安全有效的。然而,这些技术无法保持黏膜的完整性,并导致穿孔、感染和术后狭窄的高风险。黏膜下隧道内镜切除术 (STER) 是一种新的手术技术,它可以通过在黏膜下和 MP 层之间建立隧道来保持黏膜的完整性。STER 已被证明对治疗起源于 MP 层的 SMT 是有效和安全的。目前,STER 已成为治疗起源于固有肌层的胃肠道 (GI) SMT 的标准治疗方法,尤其是在中国。在本综述中,我们描述了 STER 治疗起源于 MP 层的胃肠道 SMT 的适应证、手术步骤、术后护理、疗效和安全性结果以及未来展望。