Fig. 1Standard snare polypectomy of a gastric inflammatory fibrinoid polyp. (A) A subepithelial tumor is observed at the angle. (B) The tumor is hypoechoic and located in the submucosal layer on endoscopic ultrasonography. (C) Submucosal injection is done to elevate the lesion from the proper muscle layer. (D) The tumor is resected by using a snare. (E) The lesion is completely removed. (F) Inner surface of the resected specimen.
Fig. 2Endoscopic submucosal resection of an esophageal granular cell tumor with a ligation device. (A) A subepithelial tumor is observed at the lower esophagus. (B) Saline solution with small amount of epinephrine and indigo carmine dye is injected beneath the lesion to elevate it. (C) The lesion is then aspirated into the ligation device, followed by deployment of the elastic band. (D) Snare resection is performed using blended electrosurgical current. (E) The lesion is completely removed. (F) Inner surface of the resected specimen.
Fig. 3Endoscopic submucosal dissection of an esophageal leiomyoma using electrosurgical knife. (A) A large subepithelial tumor is observed at the lower esophagus. (B) The tumor is hypoechoic and located mainly in the submucosal layer on endoscopic ultrasonography. (C) After midline incision of overlying normal mucosa, a subepithelial tumor is exposed. (D) Submucosal dissection of the tumor is performed by using an IT-knife. (E) The lesion is completely removed. (F) The resected specimen.
Table 1Main Publications Reporting Success and Complication Rates of Endoscopic Submucosal Dissection for Subepithelial Tumors
Table 2Recent Three Publications Reporting Success and Complication Rates of Endoscopic Submucosal Tumel Dissection for Subepithelial Tumors