Abstract
Fourteen of symptomatic submucosal lesions located in the esophagus (n = 4), stomach
(n = 4), duodenum (n = 1) and colon (n = 5) were treated by means of endoscopy. Treatment
selection criteria for tumours (n = 10) were presence of a pedunculated tumour, or
presence of a sessile tumour with a base smaller than 2 cm which originated in the
upper wall layers, as judged by the mobility of the lesion. All tumours but one were
successfully and completely removed by snare cauterisation. The failure was a gastric
fibroma which was incompletely resected; bleeding ensued rendering emergency surgery
necessary. Mucosal cysts in the esophagus and colon were treated by either snare polypectomy
in the case of smaller lesions or drainage in the case of larger cysts. Follow-up
for 5 to 12 months (mean 8.7 months) in the 13 cases treated by means of endoscopy
alone did not reveal recurrence. These preliminary results show that endoscopic treatment
of smaller and superficially originating submucosal tumours may be a feasible alternative
to surgery, however meticulous patient selection is necessary to avoid major complications.
