Capacity of flexible endoscopy in subepithelial esophageal tumors

Abstract

Aim of the study was to investigate the results of endoscopic diagnostics and peroral operative endoscopy in subepithelial esophageal tumors. Material and methods. Data of 21 patients underwent flexible endoscopic interventions for subepithelial esophageal tumors (SET) from 2016 till 2019 were analyzed. Main endoscopic methods to reveal and characterize tumors preoperatively are examination in white light, narrow light spectrum imaging, radial endoscopic ultrasonographic scanning. Tumors from 8 till 40 mm in maximal dimension removed by endoscopic mucosal resection (2 tumors in 1 patient), tunnel dissection (13 cases) or endoscopic submucosal dissection (7 cases). The additional endoscopic ultrasonography was demanded intraoperatively in 2 cases of difficult tumor location and blurry visualization. Results and discussion. Subepithelial esophageal tumors are mainly diagnosed occasionally in patients without symptoms related to tumor. Suspicion of the tumor was based on routine esophagogastroduodenoscopy. Following endoscopic ultrasonography of planned esophageal segment allowed rejecting or confirming the lesion (21 patients), evaluating its echoscopic structure, size, growth direction, intramural location and connection to wall layers to make an assumption related to tumor morphology, to plan way of tumor removal. We choose interventions in depends on combination of available tumor features. Technical success of endoscopic interventions with use of flexible endoscope under this approach is noted in all the patients. So endoscopic methods are important for primary and detailed diagnostics and also effective for operative treatment in cases of appropriate indications.