Endoscopic resection using band ligation for esophageal SMT in less than 10 mm

To evaluate the safety and feasibility of endoscopic resection using band ligation (EMR-B) for the diagnostic and therapeutic removal of tumors located in the esophageal subepithelial region having originated from the submucosa.

From May 2009 to September 2014, after medical chart and endoscopic ultrasonography report review, a total of 15 esophageal tumors located in the submucosal layer were resected by EMR-B. Previous symptom, location, pathology, complete resection rate, incidence of complications, incidence of minor complication, size, length of procedures time and follow up months were evaluated. To evaluate local recurrence at the resection site, periodic follow-up endoscopic examination was undertaken in all of the patients. The first endoscopic examination was performed about 6 mo after the endoscopic resection. Thereafter, the endoscopic follow up were scheduled annually.

The mean age was 50.3 ± 9.67 years. The mean tumor size was 6.93 ± 3.15 mm and most of the lesions size was between 5-10 mm in diameter (10/15, 66.6%). In all patients, endoscopic en bloc resection was achieved. In one patient, the vertical margin was involved. The mean procedural time was 8.86 ± 3.66 min. In all patients, no evidence of severe complications such as perforation or bleeding occurred. Minor complications such as chest pain (2/15, 13.3%) and heartburn (3/15, 13.3%) were reported but they symptoms were controlled by proton pump inhibitors, ulcermin and/or analgesics. Histologic assessments of the removed specimens revealed 10 granular cell tumors (66.6%), 4 leiomyomas (16.6%) and one lipoma (6.6%). No recurrence was observed during the mean follow up period of 45 ± 3.5 mo (range: 5-64 mo).

EMR-B might be considered safe and effective for the diagnosis and treatment of lesions measuring less than 10 mm in diameter.