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Submucosal Tunneling Endoscopic Resection for Upper Gastrointestinal Subepithelial Lesions: A Systematic Review and
Stavros Chrysovalantis Liapis1, Ioannis Baloyiannis2, Konstantinos Perivoliotis3
1Department of Surgery, "Achillopouleion" General Hospital, Polymeri 134, 38222, Volos, Greece.
Journal of Gastrointestinal Cancer
|April 29, 2025
Summary
Submucosal tunneling endoscopic resection (STER) offers a safe and effective method for removing upper gastrointestinal subepithelial lesions. This advanced endoscopic technique demonstrates high complete resection rates and minimal recurrence, establishing its feasibility.
Area of Science:
- Gastroenterology
- Endoscopic Surgery
- Minimally Invasive Procedures
Background:
- Subepithelial lesions in the upper gastrointestinal tract require effective and minimally invasive removal options.
- Submucosal tunneling endoscopic resection (STER) is an advanced endoscopic technique developed for such lesions.
Purpose of the Study:
- To evaluate the safety and efficacy of STER for upper gastrointestinal subepithelial lesions.
- To determine the complete resection rate, en bloc resection success, and complication profile of STER.
Main Methods:
- A systematic literature review and meta-analysis of 37 studies involving 3795 patients was conducted.
- Data were pooled using random-effects and fixed-effects models to estimate outcomes.
- Primary outcome was complete resection rate; secondary outcomes included en bloc resection, operation duration, length of stay, recurrence, and complications.
Main Results:
- STER achieved a pooled complete resection rate of 99% (95% CI 98.4-99.6%).
- En bloc resection was successful in 87.7% of cases, with a low local recurrence rate of 0.1%.
- Common complications included subcutaneous emphysema (5.5%) and pneumothorax (3%); mean operation duration was 64.2 minutes and mean length of stay was 4.93 days.
Conclusions:
- Submucosal tunneling endoscopic resection (STER) is a highly feasible and safe treatment for upper GI subepithelial lesions.
- The technique demonstrates excellent efficacy with a low complication and recurrence rate.
