Year 2025 / Volume 117 / Number 11
Letter
One stone two birds - Submucosal tunneling endoscopic resection for a large esophageal submucosal mass and esophageal diverticulum

676-677

DOI: 10.17235/reed.2024.10653/2024

De-Feng Li, Li-Yang Wang, Yan-Hui Tian, Rui-Yue Shi,

Abstract
A-35-year-old woman presented our hospital with half a year's history of solid food dysphagia. An upper gastrointestinal endoscopy revealed a large submucosal mass in an esophageal diverticulum near the gastroesophageal junction. Endoscopic ultrasound (EUS) confirmed a hypoechoic lesion arising from the muscularis propria layer with the size of 25*14 mm. Therefore, submucosal tunneling endoscopic resection (STER) was proposed to remove the large submucosal lesion in addition to targeted septotomy of the esophageal diverticula. A 2-cm longitudinal mucosal access was made at 3 cm above the submucosal lesion, and a submucosal longitudinal tunnel was created until the submucosal lesion revealed using a DualKnife (Olympus, Japan). Meticulous resection was performed with the DualKnife, and the lateral border of the lesion was dissected from muscularis propria layer. It was completely removed the lesion with en bolc resection, and dissected the septum of the diverticulum using the DualKnife. The tunnel access was closed with several hemoclips. Finally, it has been demonstrated to achieve a perfect outcome for the patient. The patient was discharged three days later with symptom resolved on follow-up and to date.
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References
1. Tong L, Hao H, Zhang Z, et al. Milk-derived extracellular vesicles alleviate ulcerative colitis by regulating the gut immunity and reshaping the gut microbiota. Theranostics 2021;11:8570-8586.
2. Quan YS, Yao J, Wang LS. Peroral endoscopic myotomy for multiple esophageal diverticula. Endoscopy 2022;54:E771-E772.
3. Estevinho MM, Pinho R, Rodrigues J, et al. Effective submucosal tunneling endoscopic resection (STER) of a giant esophageal leiomyoma. Rev Esp Enferm Dig 2023;115:746-747.
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Li D, Wang L, Tian Y, Shi R. One stone two birds - Submucosal tunneling endoscopic resection for a large esophageal submucosal mass and esophageal diverticulum. 10653/2024


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Publication history

Received: 14/07/2024

Accepted: 29/07/2024

Online First: 28/08/2024

Published: 11/11/2025

Article Online First time: 45 days

Article editing time: 485 days


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