Standard Probe Endoscopic Ultrasonography before Endoscopic Submucosal Dissection Avoids Misjudging the Size of Esophageal and Gastric Stromal Tumors by Miniprobe Sonography
10.3969/j.issn.1008-7125.2017.02.002
- VernacularTitle:内镜黏膜下剥离术前内镜超声标准超声探头检查避免微探头对食管胃间质瘤大小的误判
- Author:
Xiaofan WANG
;
Zheng LI
;
Shan GAO
;
Shiyun TAN
;
Lei SHEN
;
Mingkai CHEN
;
Jiwang CAO
- Keywords:
Endoscopic Ultrasonography;
Standard Probe;
Miniprobe;
Endoscopic Submucosal Dissection;
Gastrointestinal Stromal Tumors;
Diagnosis
- From:
Chinese Journal of Gastroenterology
2017;22(2):70-74
- CountryChina
- Language:Chinese
-
Abstract:
Endoscopic ultrasonography (EUS)is routinely performed before endoscopic submucosal dissection (ESD)for treatment of upper gastrointestinal stromal tumors.However,when a miniprobe sonography (12,15 and 20 MHz)was used,the size of tumor revealed by EUS was often inconsistent with what it actually was,which might increase the difficulty of ESD and the risk of perforation and massive bleeding.Aims:To investigate the value of standard probe (5 and 7.5 MHz)EUS in detecting the size of upper gastrointestinal stromal tumors before ESD.Methods:Clinical data of patients who were suspicious of esophageal and gastric stromal tumors by gastroscopy and EUS from Jan.2012 to Oct.2014 at the Renmin Hospital of Wuhan University were collected.Of them,195 cases treated by ESD were retrospectively analyzed.Results:Of 195 cases treated by ESD,37 cases diagnosed by standard probe EUS and 108 cases diagnosed by miniprobe EUS were confirmed as stromal tumors by pathology.Fourteen cases were failure for ESD and then transferred to surgical treatment,one was due to misjudgement of the origin of tumor by standard probe EUS and 9 were due to misjudgement of the size of tumor by miniprobe EUS.The misjudgement rate of standard probe EUS was lower than that of miniprobe EUS with an insignificant difference (2.7%vs.8.3%,P>0.05).In 9 cases misjudged by miniprobe EUS, the size of tumor presented by miniprobe EUS was significantly smaller than its real size [(1.22 ±0.51)cm vs.(3.97 ±1.06)cm,P<0.01].ESD was avoided or terminated in 3 cases because of the accurate estimation of tumor origin, structure and blood flow by standard probe EUS.Conclusions:For patients who are going to receive ESD for suspected upper gastrointestinal stromal tumors,it would be best to select standard probe EUS to detect the size,origin and blood flow of the tumor before ESD.It will decrease the risk and improve the success rate of ESD.
