SUBMUKOZAL TÜNEL İLE ENDOSKOPİK REZEKSİYON YÖNTEMİNİN ÜST GASTROİNTESTİNAL KANAL SUBEPİTELYAL TÜMÖRLERİNİN TEDAVİSİNDEKİ YERİ: TERSİYER MERKEZ DENEYİMİ

Öz

Giriş ve amaç: Submukozal tünel ile endoskopik rezeksiyon yöntemi muskularis propria tabakasından kaynaklanan subepitelyal lezyonların tedavisinde seçeneklerden birisidir. Bu çalışmada üst gastrointestinal kanaldaki subepitelyal lezyonların tedavisinde submukozal tünel ile endoskopik rezeksiyon yönteminin etkinliği ve güvenilirliği değerlendirildi. Gereç ve yöntem: Ocak 2020- Şubat 2024 tarihleri arasında submukozal tünel ile endoskopik rezeksiyon yöntemi ile rezeke edilen hastaların demografik verileri tarandı. submukozal tünel ile endoskopik rezeksiyon işleme ait prosedural detaylar ile subepitelyal lezyonların histopatolojik verileri incelendi. Çalışmanın primer sonlanım noktası submukozal tünel ile endoskopik rezeksiyon işlemi ile ilişkili teknik başarı ve en bloc rezeksiyon oranlarıydı. Bulgular: Toplamda 23 hastadaki 23 subepitelyal lezyon çalışmaya dahil edildi. Ortalama tümör çapı 26.78 mm’di (aralık 10-55 mm). Lezyonların %56.5’sı (13/23) özofagusta lokalizeydi. Ortalama işlem süresi 61.82 dakikaydı (aralık 22-132 dakika). Teknik başarı oranı %100’dü. En bloc rezeksiyon oranı ise %86.9’dü. Per-op komplikasyon hastaların %39.1’inde gelişti. Cerrahi tedavi gerektiren komplikasyon olmadı. Medyan hastane yatış süresi 1 gündü (aralık 1-2 gün). Histopatolojik değerlendirmeye göre lezyonların 17’sine leiomyom, 4’üne gastrointestinal stromal tümör ve 2’sine ektopik pankreas tanısı kondu. Medyan 16 aylık (aralık 6-36 ay) izlemde rekürrens gözlenmedi. Sonuç: Submukozal tünel ile endoskopik rezeksiyon yöntemi, üst gastrointestinal kanaldaki muskularis propria kaynaklı subepitelyal lezyonların tedavisinde etkili ve güvenilir bir yöntemdir.

Anahtar Kelimeler

• subepitelyal lezyon
• submukozal tünel
• endoskopi

SUBMUCOSAL TUNNELING ENDOSCOPIC RESECTION IN THE TREATMENT OF SUBEPITHELIAL TUMORS OF THE UPPER GASTROINTESTINAL TRACT: A TERTIARY CENTER EXPERIENCE

Öz

Introduction and Aim: Submucosal tunneling endoscopic resection (STER) is one of the treatment options for subepithelial lesions originating from the muscularis propria layer. This study aims to evaluate the efficacy and safety of the STER technique in the treatment of subepithelial lesions in the upper gastrointestinal tract. Materials and Methods: Demographic data of patients who underwent submucosal tunneling endoscopic resection between January 2020 and February 2024 were reviewed. Procedural details of the STER technique and histopathological data of the subepithelial lesions were analyzed. The primary endpoints of the study were the technical success rate and en bloc resection rate associated with the STER procedure. Results: A total of 23 subepithelial lesions in 23 patients were included in the study. The mean tumor diameter was 26.78 mm (range 10-55 mm). Of the lesions, 56.5% (13/23) were localized in the esophagus. The mean procedure time was 61.82 minutes (range 22-132 minutes). The technical success rate was 100%. The en bloc resection rate was 86.9%. Perioperative complications occurred in 39.1% of the patients, with no complications requiring surgical intervention. The median hospital stay was 1 day (range 1-2 days). Histopathological evaluation revealed that 17 lesions were diagnosed as leiomyomas, 4 as gastrointestinal stromal tumors, and 2 as ectopic pancreas. No recurrences were observed during a median follow-up of 16 months (range 6-36 months). Conclusion: Submucosal tunneling endoscopic resection is an effective and safe technique for the treatment of subepithelial lesions originating from the muscularis propria in the upper gastrointestinal tract.

Anahtar Kelimeler

• subepithelial lesion
• endoscopy
• submucosal tunneling

Kaynakça

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