Role Of Endoscopic Ultrasound In Protuberances Of Esophagus With Smooth Surface

ObjectiveWith the wide application of endoscopic ultrasound, protuberances of esophagus with smooth surface can be diagnosed clearly. Endoscopic ulrrasonography has become a major means of guidance in diagnosis, differential diagnosis and guiding treatment of protuberances of esophagus.By analyzing and summarizing the clinical data of 330 patients from the First Affiliated Hospital of Zhengzhou University who had protuberances of esophagus with smooth surface diagnosed and treated by micro-probes endoscopic ultrasound, the research discusses the role of endoscopic ultrasound in diagnosis and treatment of protuberances of esophagus with smooth surface, and provides relating basis for clinical diagnosis and treatment.Material and MethodTo analyze and summarize the data of three hundred and thirty patients with protuberances of esophagus with smooth surface detected by ordinary gastroscope from May 2007 to 2010 in our hospital, among them one hundred and eight patients were treated by endoscopy and seven ones had surgery. All patients were examined by ultrasonic endoscopy. Record the patients'ages, sexes, major clinical manifestations.Make sure the blood routine, profhrombin time and electrocardiogram have been done before treatments, eliminate hemorrhagic diseases and the serious diseases of heart and/or lung and so on, sign the information consent form, and inform the benefits and risks.Depend on the result from endoscopic ultrasound, choose different treatments,100 patients were treated by endoscopic mucosal resection,8 patients looped by nyloning,7 patients treated by surgical operation. In addition, two hundred and fifteen patients refused treatment or had no use who were observed dynamicly. The postoperative treatments of the patients who were dealed with endoscopic theapy were to abrosia for at least 1 days or more,and give proton pump inhibitor to inhibit acid, hemostasis, protect gastric mucosa, and do anti-infection processing, ask them to come back to the hospital for a check by gastroscope after two or three months, observe the healing of wound and follow-up.Result1. Three hundred and thirty cases of protuberances of esophagus with smooth surface are respectively leiomyomas, mesenchymal tumors, venous tumors, cysts and extraesophageal pressures.Among them most are leiomyomas that accounts for 66.1 percent.2. Protuberances of esophagus with smooth surface are common in lower-middle section, and these patients lack typical clinical manifestation.3. One hundred patients treated by endoscopic mucosal resection (EMR), and the pathological changes were resected completely in one time. And there were no complications such as hemorrhage and perforation. Postoperative pathology included: 94 leiomyomas,3 interstitialomas,1 cavernous hemangioma,1 granular cell tumor,1 cyst.8 patients by loop ligature, lesions were treated in one time. After two months, uplift venereal change all fell off completelly. Seven patients underwent surgical treatment, postoperative pathology including:5 leiomyomas,2 stromal tumors; the coincidence between endoscopic ultrasonography and pathology was 94.4%.Conclusions1. Endoscopic ultrasonography is more valuable in diagnosis of protuberances of esophagus with smooth surface.2. Protuberances of esophagus with smooth surface are common in lower-middle section, and most are leiomyomas.3. EMR is appropriate in treatment of protuberances of esophagus with smooth surface of whose diameter are not more than 2 centimeters and originated in the submucosal.4. EMR is safe, effective, minimally invasive and economical and obtain complete pathological diagnosis.5. Various treatments guided by endoscopic ultrasound are complementary, have high safety, low cost, quick recovery.