Experience of endoscopic treatment of patients with gastrointestinal stromal tumors of the esophagus

Aim. To evaluate the technical capabilities and outcomes of endoscopic treatment of patients with gastrointestinal stromal tumors of the esophagus. Materials and Methods. A retrospective analysis of the examination and treatment results of 5 patients with gastrointestinal stromal tumors of the esophagus was conducted. The average age of the patients was 59 years (range, 35-72 years). Clinical symptoms of dysphagia were observed in 2 patients, while 3 cases were asymptomatic. Preoperatively, all patients underwent chest computed tomography, esophagogastroduodenoscopy, and endoscopic sonography; in some cases, magnetic resonance imaging was also performed. In all cases, the tumors corresponded to type III according to the endoscopic classification of nonepithelial neoplasms of the upper gastrointestinal tract. In 3 patients, the tumors were localized in the middle third of the esophagus, and in 2 patients, in the lower third. The average tumor size was 25 mm (range, 19-46 mm). Results. In all 5 cases, the tumors were removed using submucosal tunnel dissection; the technical success rate was 100%. Morphological and immunohistochemical studies confirmed the diagnosis of gastrointestinal stromal tumor of the esophagus in all cases. One case showed signs of high proliferative activity, which prompted adjuvant therapy. Surgery duration ranged from 55 to 175 minutes. Two patients experienced adverse events, including subcutaneous emphysema of the neck and chest. There were no deaths or complications that significantly impacted the postoperative course. Follow-up examinations, which included computed tomography and esophagogastroduodenoscopy, were conducted 12 months to 6 years later. No signs of tumor recurrence were detected. Conclusion. Endoscopic removal of esophageal gastrointestinal stromal tumors using submucosal tunnel dissection is an effective, safe, and minimally invasive approach. The results suggest this method as a modern and preferred alternative to traditional surgical interventions for patients with esophageal stromal tumors.