A Clinical Analysis Of Endoscopic Treatment For Esophageal Protruded Lesion

Objective:To evaluate the value and complications of different endoscopictreatments for esophageal protruded lesion.Methods: A total of66patients withesophageal protruded lesions whodiagnosed by gastroscopy, ultrasonic gastroscopy and CT from September2011toDecember2012underwent endoscopic mucosal resection （EMR）,endoscopicsubmucosal dissection（ESD） and submucosal tunneling endoscopic resection（STER），including38male and28female，age from33years to72years，for furtheranalysis.Results:1.Therewere68lesionsin66patients, of which66lesions obtained enbloc resection with endoscopic resection，2lesions in esophageal external cavitystopped treatment. These lesions which obtained endoscopic therapeutics,21cases(28.85%) located in the upper of esophagus while23cases (34.85%) in the middleand22cases（33.33%）in the lower successfully got resection without perforation,hemorrhage, pneumothorax, esophageal stricture and other severe complications. Ofall tumors,37cases healed by EMR,14cases resected by ESD and15cases cured bySTER. Postoperative histological confirmed that those lesions resected with noresidual disease.It was6.11±3.47mm that mean tumor size in the group of EMR. Itwas14.07±9.56mm that mean tumor size in the group of ESD. It was15.31±6.28mmthat mean tumor size in the group of STER. The size of tumor resected by ESD largerthan the group of EMR was statistically significant（P<0.001）, The size of tumorresected by STER larger than the group of EMR was statistically significant（P<0.001）.The location of tumor of three groups differed significantly（P=0.001）.2.Pathological diagnosis of the benign tumors were leiomyoma (46/66),gastrointestinal stromal tumor (GIST)(2/66), cysts (3/66),polypoid hyperplasia(2/66),non-polypoid hyperplasia(4/66) and granular cell tumor (1/66).Other caseswereatypical hyperplasia, including low-grade intraepithelial neoplasia (2/66), high-grade intraepithelial(4/66). The follow-up period after the procedure was6±3.5months. No residual or recurrent tumors were detected in6patients during thefollow-up period.3.35patients were followed up for1month，including15cases in EMR，10casesin ESD,10cases in STER.5cases of esophageal mucosaoccurred hyperplasia,2casesdeveloped to scar after EMR.3cases of esophageal mucosaoccurred hyperplasia,7cases developed to scar after ESD.9cases of esophageal mucosaoccurred hyperplasia,1case developed to scar after STER. No stricture occurred in any patient during thefollow-up period. The proportion of patients whose esophageal mucosatransformedwas significantly different after ESD and STER（P=0.02）.The esophagealmucosa was associated with forming scar easily after ESD. STER may causeesophageal mucosal hyperplasia.Conclusion: Esophagealprotruded lesionscan be detected inany part oftheesophagus.Endoscopic therapeutics, involving EMR，ESD and STER appear to besafe and effective procedure for esophageal protruded lesions. However, esophagealmucosal will lead to hyperplasia and develop to scar after ESD and STER.