Comparison Between Submucosal Tunneling Endoscopic Resection (STER) and Other Resection Modules for Esophageal Muscularis Propria Tumors: A Retrospective Study

BACKGROUND: Surgery has been considered to be the primary approach for resection of esophageal muscularis propria tumors. With the development of endoscopic technology, new techniques such as endoscopic submucosal dissection (ESD) and submucosal tunneling endoscopic resection (STER) have emerged for resecting these lesions. Previous studies have demonstrated that STER might be an intriguing alternative. This study aimed to evaluate the clinical value of STER by comparing it to other resecting modules. MATERIAL/METHODS: Clinical outcome and data were retrospectively collected from patients with esophageal muscularis propria tumors who underwent resection either endoscopically or thoracoscopically. The clinical data were statistically analyzed. RESULTS: A total of 137 patients were enrolled. They were divided into 3 groups: a STER group (27 patients), an ESD group (42 patients), and a thoracoscopic enucleation (TE) group (68 patients). There were no significant differences among the 3 groups in gender, age, pathological type of tumors, or major adverse events (P>0.05). However, the STER group had the shortest duration of hospitalization and the lowest cost (P<0.05). Furthermore, the STER group was superior in operation time and the location of tumors to the TE group. Moreover, STER outperformed ESD in the resection of large tumors (P<0.05). Although STER had the lowest en bloc resection rate, no recurrence or metastasis was noted during a mean follow-up of 22.14 months (range 3 to 60 months). CONCLUSIONS: STER is a feasible, safe, and effective approach for the resection of esophageal muscularis propria tumors ≤40 mm. We recommend STER as a potent alternative for these tumors.