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

AIM: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.METHODS: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.RESULTS: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).CONCLUSION:EMR-B might be considered safe and effective for the diagnosis and treatment of lesions measuring less than 10 mm in diameter.