Abstract:

Objective    To explore the methods of endoscopic dissection of esophageal mesenchymal tumors and to evaluate their safety and efficiency for the treatment  of esophageal mesenchymal tumors. Methods    Endoscopic electrosection or submucosal dissection was performed in 39 cases of esophageal mesenchymal tumors. The tumors which originated from mucosal muscularis determined by endoscopic ultrasonography (EUS) and were less than 1.0cm in diameter were resected by snare electrosection. The tumors which originated from mucosal muscularis and were more than 1.0cm in diameter, which were too flat to snare, or which originated from muscularis propria determined by EUS were resected by endoscopic submucosal dissection ( ESD). Results    Comeplete resection rate: the tumors originating from mucosal muscularis in all the 28 cases were comepletely resected. In the 11 cases whose tumors originated from muscularis propria, much bleeding was not successfully controlled by the endoscopy and was then treated by surgery in 1, the tumor adhered to the muscularis propria and was not resected by the endoscopy in 2, and the comeplete resection rate was 72.7%. There was a significant difference in comeplete resection rate between the two groups（P＜0.05）. Complications: 1 case had bleeding and no one had perforation in the 28 cases whose tumors originated from mucosal muscularis, and the complication rate was 3.5%; 2 cases had bleeding and 2 cases had perforation in 11cases whose tumors originated from muscularis propria, and the complication rate was 36.3%. There was a significant difference in complication rate between the two groups（P＜0.05）. Conclusion    It is safe and effective to conduct endoscopic resection for esophageal  mesenchymal tumors originating from mucosal muscularis.  For tumors originating from muscularis propria, the comeplete resection rate decreases and the complication rate increases, and they should be treated by surgery.

Key words: Esophageal mesenchymal tumors; Endoscopic ultrasonography; Endoscopic electrosection