• Tao Chen, Chen Zhang, Li-Qing Yao, Ping-Hong Zhou, Yun-Shi Zhong, Yi-Qun Zhang, Wei-Feng Chen, Quan-Lin Li, Ming-Yan Cai, Yuan Chu, and Mei-Dong Xu.
• Endoscopy Center, Zhongshan Hospital, Fudan University, Shanghai, China.
• Endoscopy. 2016 Feb 1; 48 (2): 149-55.

Background And Study AimsSubmucosal tunneling endoscopic resection (STER) has become a potential option for the endoscopic treatment of a selected group of patients with submucosal tumors (SMTs) originating from the muscularis propria layer in the upper gastrointestinal tract. The aim of this retrospective study was to analyze the incidence and management of STER-related complications.Patients And MethodsFrom January 2011 to August 2013, 290 patients with upper gastrointestinal SMTs treated by STER were included in the study. Clinicopathological characteristics and complication data were collected and analyzed retrospectively.ResultsMucosal injury occurred in three cases (1.0 %) and major bleeding occurred in five cases (1.7 %). The gas-related complications were very common; however, only nine cases of major pneumothorax (> 30 % lung collapse) needed therapeutic intervention (3.1 %). Thoracic effusion occurred in 49 patients, 11 of whom had low grade fever or segmental atelectasis that required thoracentesis and drainage (3.8 %). Thus, although the overall incidence of complications was 23.4 % (68/290), only 10.0 % of procedures (29/290) required intervention for complications. Based on the statistical analysis, irregular shape, tumor in the deep muscularis propria layer, long procedure time, and air insufflation were risk factors of STER-related major complications.ConclusionAlthough the incidence of STER-related complications was relatively high, most of these complications were minor and did not require therapeutic intervention. STER is a safe technique for the treatment of upper gastrointestinal SMTs.© Georg Thieme Verlag KG Stuttgart · New York.

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