Endoscopic resection techniques of benign esophageal tumors: literature review

Objective: Minimally invasive endoscopic techniques for benign esophageal tumors (BET) resection include endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), submucosal tunneling endoscopic resection (STER), endoscopic submucosal excavation (ESE), and endoscopic fullthickness resection (EFTR). In this study, we describe the aforementioned procedures and provide a review of their indications, pros and cons, and outcomes. Background: Esophageal benign tumors are uncommon lesions; however, they have been increasing in frequency in recent years. The majority are asymptomatic with dysphagia being the most common presenting symptom. Several endoscopic techniques have been reported for the resection of BET with various outcomes. Methods: Electronic databases were searched by two reviewers for published literature on endoscopic resection of BET. Articles regarding resection of malignant or premalignant esophageal lesions or nonesophageal tumors were excluded from the study. Data from the published articles were recorded including study period, technique, population number, tumor size, and location as well as recurrence rate, postprocedural complications, and follow-up. Conclusions: Endoscopic resection of BET is feasible with low complications and recurrence rates. Tumor confined to the mucosal and submucosal layer can be resected with EMR or ESR according to the tumor size. Tumor with Muscularis Propria involvement can be resected with STER or EFTR. ESE can be considered for gastroesophageal junction tumors. Larger scale comparative prospective studies are required for assessment of the described techniques' efficacy, complications, and long-term outcomes.