To investigate the value of endoscopic submucosal tunnel resection of large area esophageal mucosal lesions.

Between January 2015 and June 2017, 18 patients with large area esophageal high grade epithelial neoplasia confirmed by pathology were collected.All the patients were divided into two groups using random number table method.The patients in control group were treated with traditional endoscopic submucosal dissection(ESD), and the patients in test group were treated with submucosal tunnel resection.The therapeutic effect of the two groups were observed and compared.

The total removal rate of the tunnel group was 100%.In the classic ESD group, 1 case was fractionally excised by a snare, and the total removal rate was 88.9%.The postoperative pathological results showed that the lateral cutting edge and basal cutting edge of the excised specimen were complete in the two groups of lesions.The maximum diameters in tunnel group and classic ESD group were(7.5±3.2)cm and(8.3±1.4)cm respectively, and the difference of the lesion resection area was not statistically significant between the two groups(P>0.05). The operation times in tunnel group and classic ESD group were(50.4±28.0)min and(82.5±29.7)min.There was significant difference between the two groups in lump-sum slice and average operation time(P<0.05). There was no subcutaneous emphysema in tunnel group, and the stripping process has no ring muscle injury.In classic ESD group, there were 2 cases of mediastinal and subcutaneous emphysema, of which 1 case of small perforation was applied with titanium clip, and the emphysema disappeared by itself 3 days after operation.There was a fever of 1 in 24 h after operation, accompanied by elevated white blood cell, and the symptom was completely relieved in the second day after treatment.The incidence of complications between the two groups has significant statistical significance(P<0.05).

Using submucosal tunnel technology for the treatment of large area esophageal mucosal lesion is a safe and effective method.It can effectively reduce the difficulty of endoscopic lesion resection, shorten the operation time, and reduce the complications.

Esophagus; High grade epithelial neoplasia; Endoscopic submucosal tunnel technique; Endoscopic mucosal dissection