Endoscopic tunnel dissection in the submucosal layer for a large duplicating cyst of the esophagus

Background. Esophageal duplication cyst is a rare condition that requires an individualized approach to both diagnosis and treatment selection. In recent years, the endoscopic minimally invasive approach has gained increasing popularity, demonstrating a low complication rate in the treatment of patients with submucosal tumors of the esophagus. Clinical case. A 45-year-old female patient presented with complaints of dysphagia and epigastric pain. Endoscopic examination revealed an elongated esophageal duplication cyst. After thorough diagnostics of the neoplasm, a decision was made to perform endoscopic removal of the cyst using the submucosal tunnel dissection method. Results. The use of endoscopic tunnel dissection for the removal of an esophageal duplication cyst is presented. A follow-up endoscopic examination was performed three months after surgery and revealed no cyst recurrence, stenosis, or pathological changes in the mucosa in the surgical area. Conclusion. The use of an intraluminal endoscopic approach to treat a patient with a large esophageal duplication cyst, including tunnel dissection in the submucosa and fragment-by-fragment excision of the cyst walls, enabled organ-preserving surgery, thereby reducing the risk of intraoperative and postoperative complications. Despite the large size of the cyst, this method achieved good clinical and functional results due to the absence of an esophageal wall defect and the ability to completely close the access tunnel.