Gastroenterology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Gastroenterology and Endoscopy Unit, Fondazione Istituto Gemelli-G.Giglio, Cefalù, (Palermo), Italy.
Best Pract Res Clin Gastroenterol. 2024 Aug;71:101931. doi: 10.1016/j.bpg.2024.101931. Epub 2024 Jun 27.
The concept of submucosal space, or rather the "third space", located between the intact mucosal flap and the muscularis propria layer of the gastrointestinal tract, represents a tunnel that the endoscopist could use to perform interventions in the muscularis propria layer or breech it to enter the mediastinum or the peritoneal cavity without full thickness perforation. The tunnel technique can be used both for the removal of mucosal tumours, called endoscopic submucosal tunnel dissection (ESTD), for the removal of subepithelial tumours (SELs), called submucosal tunnelling endoscopic resection (STER), and for the removal of extra-luminal lesions (for example in the mediastinum or in the rectum), called submucosal tunnelling endoscopic resection for extraluminal tumours (STER-ET). Aim of this updated narrative review, is to summarize the evidences that analyses indications, and outcomes of tunnelling techniques for the treatment of above mentioned lesions.
黏膜下空间的概念，或者更确切地说是“第三空间”，位于完整的黏膜瓣和胃肠道的固有肌层之间，代表了一个隧道，内镜医师可以使用该隧道在固有肌层进行干预，或者突破固有肌层进入纵隔或腹膜腔，而不会造成全层穿孔。隧道技术可用于切除黏膜肿瘤，称为内镜黏膜下隧道剥离术（ESTD），也可用于切除黏膜下肿瘤（SELs），称为黏膜下隧道内镜切除术（STER），还可用于切除腔外病变（例如纵隔或直肠），称为腔外肿瘤黏膜下隧道内镜切除术（STER-ET）。本更新的叙述性综述的目的是总结分析用于治疗上述病变的隧道技术的适应证和结果的证据。
