The Ideal Approach to Esophageal Subepithelial Tumors Is an Endoscopic Approach

The focus of this review is endoscopic resection (ER) of esophageal subepithelial tumors (SETs) as an alternative to surgical resection. We briefly review relevant background information on the epidemiology and current guidelines for the management of esophageal SETs and then proceed to discuss in detail ER for these tumors. Submucosal Tunnel Endoscopic Resection (STER) has emerged as the dominant ER technique for esophageal SETs. We review this technique and its outcomes and summarize comparative data versus other endoscopic techniques and, importantly, versus surgical approaches. The latter comparison represents the main focus of this review as part of the endoscopy versus surgery debate format of this issue. We conclude that, with proper case selection, STER offers an equally efficacious but less invasive alternative to surgery for resection of esophageal SETs.