Treatment strategy and clinical outcomes of thoracoscopic endoscopic cooperative surgery for submucosal tumors in the esophagus.

Abstract

Purpose: Recently, submucosal tumors (SMTs) of the esophagus have been treated with peroral endoscopic tumor resection (POET) and a new procedure called thoracoscopic endoscopic cooperative surgery (TECS). This study aimed to validate the treatment strategy for SMTs and determine whether or not TECS is a viable option when POET is not feasible.

Methods: POET and TECS were performed in 12 patients between February 2020 and January 2024. The clinical characteristics and perioperative outcomes were retrospectively evaluated.

Results: Six patients were included in each group, with most of the tumors located in the middle thoracic esophagus (75%). The general anesthesia duration was significantly longer in the TECS group than in the POET group (P < 0.001), but no significant differences in endoscopic procedure time, tumor mass index, oral intake date, or length of hospital stay were observed between the two groups. En bloc and R0 resections were performed in all patients. One patient in the TECS group experienced a Clavien-Dindo grade 3a adverse event, and no tumor recurrence occurred during the median follow-up period of 33 (range, 6-53) months.

Conclusion: TECS is a safe and feasible option for SMTs when POET is difficult to perform.