The Role Of Endoscopic Ultrasonography In The Treatment And Diagnosis Of Esophageal Mucosal And Submucosal Tumors

Part Ⅰ The role of Endoscopic Ultrasonography in the treatment and diagnosis of esophgeal mucosal tumors.Objective:To study the role of Endoscopic ultrasonography combining with endoscopic techniques (including Endoscopic mucosal resection, Endoscopic submucosal dissection) and surgery in the treatment and diagnosis of esophageal mucosal tumors.Methods:A total of16lesions were eligible for inclusion in the study during the period between January2010and January2012. There were26males and6females. The mean age was60.4years. Esophageal mucosal tumors observed by conventional endoscopy were detected by EUS, EUS image findings compared with endoscopic and surgical postoperative pathological results (including pathological type, origin) for statistical analysis, analysis of accuracy rates.Results:EUS image findings of the polyps in16patients, the early esophageal cancer and precancerous lesions in16patients. According to the pathological result, diagnostic accuracy rate of EUS image findings of mucosal tumors was100%(32/32), the accuracy rate of EUS origin layer was96.88%(31/32);Conclusion:EUS is the most accurately technique for detecting the esophageal’s structure layer, determining origin and estimating the biological behavior of the tumors. Therefore EUS findings can be one of the most important keys for the doctors and patients to determine the treatment methods of the lesions, especially when highly suspected early esophageal cancer and precancerous lesions, EUS examination should be preformed before the surgery. Part II The role of Endoscopic Ultrasonography in thetreatment and diagnosis of esophgeal submucosal tumors.Objective:To study the role of Endoscopic ultrasonography combining with endoscopic Endoscopic submucosal dissection and surgery in the treatment and diagnosis of esophageal submucosal tumors.Methods:A total of104lesions in102patients were eligible for inclusion in the study during the period between January2010and January2012. There were78males and24females. The mean age was53.3years. Esophageal mucosal tumors observed by conventional endoscopy were detected by EUS, EUS image findings compared with endoscopic and surgical postoperative pathological results (including pathological type, origin) for statistical analysis, analysis of accuracy rates.Results:EUS image findings Leiomyoma in78patients, the leiomyosarcoma in8patients, the gastrointestinal stromal tumor in12patients, the vascular tumors in4patients and lipoma in2patients. According to the pathological result, confirmed leiomyoma in67patients, the leiomyosarcoma in7patients, gastrointestinal stromal tumor in12patients, the vascular tumors in4patients and lipoma in2patients. The pooled diagnostic accuracy rate of EUS image findings of submucosal tumors was88.5%(92/104), the accuracy rate of EUS origin layer was97.1%(101/104);Conclusion:EUS is the most accurately techinque for detecting the esophageal’s structure layer, determining origin and estimating the biological behavior of the tumors. Therefore EUS findings can be one of the most important keys for the doctors and patients to determine the treatment methods of the lesions, EUS examination should be preformed before the surgery.