Successful leiomyoma removal with STER shows promise for future cases
The procedure was successfully performed by team in the Esophageal and Thoracic Surgery Program at Children’s National, including Timothy Kane, MD, and Mikael Petrosyan, MD, MBA, who co-authored a case study.
Pediatric surgeons at Children’s National Hospital successfully removed a pediatric esophageal leiomyoma, a rare, benign tumor of the esophagus, through minimally invasive submucosal tunneling and endoscopic resection (STER) rather than the standard of care endoscopic submucosal dissection (ESD) technique that has traditionally had higher complication rates.
The procedure was successfully performed by team in the Esophageal and Thoracic Surgery Program at Children’s National, including Mikael Petrosyan, MD, MBA, and Timothy Kane, MD, who co-authored a case study, Submucosal Tunneling and Endoscopic Resection of an Esophageal Leiomyoma in a 13‑Year‑Old Male, in the Annals of Surgical Oncology about the case.
What it means
A 13-year-old male presented with dysphagia (difficulty swallowing) and frequent abdominal pain and was diagnosed with a 2-cm distal esophageal mass. The team completed full resection of the mass with no complications. At 1-year post-surgery, the patient continued to show no signs of dysphagia, gastroesophageal reflux, or chest pain.
In the case study, the authors write that the successful application of STER “represents a valuable advancement in the endoscopic management of submucosal tumors (SMTs), offering a less invasive and potentially safer approach for tumor removal.”
They assert that while ESD, the current most common approach, also involves removing lesions endoscopically, “ESD involves direct dissection of the lesion, potentially leading to larger mucosal defects and increased risk of complications. STER, with its tunnel approach, maintains mucosal integrity, potentially leading to better outcomes.”
Children’s National leads the way
The Esophageal and Thoracic Surgery Program at Children’s National is a national leader in pioneering more precise and less invasive procedures for children who have diseases and disorders of the lungs, mediastinum and esophagus.
For example, Children’s National performs more peroral endoscopic myotomy (POEM) procedures as a primary intervention for children with esophageal achalasia and pediatric gastroparesis than any other hospital in the United States.
Minimally invasive procedures for children with these conditions are particularly challenging due to a child’s small anatomy and a lack of right-sized surgical tools. The application of endoscopic procedures such as STER and POEM offer fewer risks of complications and faster recovery times than the current standard approaches for children. Though many of these procedures are readily available for adults, applying them in pediatrics requires technical skill and expertise not available everywhere.
Read the case study, “Submucosal Tunneling and Endoscopic Resection of an Esophageal Leiomyoma in a 13‑Year‑Old Male, in the Annals of Surgical Oncology.
