| Theme |
Gastrointesinal Submucosal Tumor -- Advances in the Diagnosis and Treatment |
| Title |
Treatment of Submucosal Tumors of the Esophagus |
| Author |
Haruhiro Inoue |
Department of Surgery, Tokyo Medical and Dental University, School of Medicine |
| Author |
Takehisa Iwai |
Department of Surgery, Tokyo Medical and Dental University, School of Medicine |
| [ Summary ] |
Submucosal tumors derived from the mucosa or submucosa are generally excised by endoscopic polypectomy or endoscopic mucosal resection. On the other hand, submucosal tumors originating from the muscle layer proper or deeper have so far been, resected through thoracoscopy or laparoscopy. Recently, Oyama et al. have reported a technique which enables (endoluminal) endoscopic excision of leiomyoma, derived from the internal circular layer. According to their report, surface mucosa of SMT is first resected endoscopically with the EMR technique, and then a target SMT is excised by snare strangulation through the mucosal defect. Most of the leiomyoma in the esophagus originate from the internal circular layer and are relatively easily resected by using Oyama's procedure. Surgical stress after Oyama's procedure is generally considered to be lower than with the thoracoscopic approach. Other leiomyoma derived from the outer longitudinal muscle layer should be resected with the thoracoscopic approach. |