| Objective:To assess the value of endoscopic ultrasonography (EUS) in the diagnosis of gastrointestinal mesenchymal tumors, and its effect and safety of guiding the endoscopic therapy.Methods:Patients with protuberances diagnosed by endoscopy were examined by EUS. Those who were diagnosed as mesenchymal tumors underwent different methods of endoscopic therapy according to their manifestations of EUS.Results:We found 370 leiomyomas and 403 stromal tumors by EUS, and the most common locus was esophagus (95.95%) and stomach (83.37%) respectively. Of these patients,111 cases received endoscopic therapy. Among 66 patients with leiomyomas, 24 cases derived from mucosa (m),36 from muscularis mucosa (mm),5 from submucosa (sm) and 1 from proper muscle layer (pm). On the other hand, we found 45 stromal tumors, of which 15 cases derived from mm,3 from sm when the tumor located in the esophagus while 1 from mm,10 from sm and 16 from pm in the stomach. They were treated by different methods according to their manifestations of EUS.64 leiomyomas and 23 stromal tumors were treated by electrocoagulation,1 leiomyoma and 8 stromal tumors were treated by nylon loop ligation,6 stromal tumors were treated by endoscopic submucosal dissection (ESD),7 stromal tumors were treated by endoscopic mucosal resection (EMR),1 leiomyoma was treated by argon plasma coagulation (APC) and 1 stromal tumor was treated by combination of ligation and electrocoagulation under endoscopic guidance. All the operations were succeeded and no complications were occurred. No recurrence was found during the follow-up. One patient underwent surgery for the pathological diagnosis of carcinoid.Conclusions:EUS plays an important role in the diagnosing and treatment of gastrointestinal mesenchymal tumors. The lesions can be treated safely and effectively by endoscopy. EUS should routinely be performed on all presumptive mesenchymal tumors before treatment. |
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