Abstract

Introduction Gastric subepithelial lesions (SEL) have a broad differential including malignant disease. Endoscopic ultrasound (EUS) ± fine needle aspiration (FNA) has become essential in assessing and managing SELs. The optimum assessment and follow-up strategy for lesions 20 mm) of patients undergoing EUS for gastric SELs in our regional centre. Methods We undertook a retrospective analysis of our prospectively collected regional EUS database of patients who underwent EUS for SELs. Electronic patient records were analysed to obtain data including imaging, cytopathology and follow-up. Patients with SELs out-with the stomach and those undergoing investigation of known malignancy were excluded. Results 132 patients underwent EUS for an SEL identified on endoscopy (96.2%) or CT scan (3.8%). Mean age was 59 years with 31 (44%) male. 81 (64%) underwent endoscopic biopsy pre-EUS. Mean lesion size was 23.2 mm. All patients were followed up for a minimum of 12 months. 18 (13.6%), 58 (43.9%), and 54 (40.9%) lesions were 20 mm respectively. Three patients had EUS reported as normal/submucosal thickening only. 78 of the 81 biopsy results of SELs at initial endoscopy provided no diagnostic value. 47 (35.6%) patients underwent FNA of lesion, (0%,12% and 72% of patients for size 20 mm respectively). 5 (3.8%) SELs were not sampled due to patient factors. 27 (57%) of EUS-FNAs were diagnostic: 20 (42.5%) were proven GIST, 3 (6.3%) leiomyoma, 3 (6.3%) other malignancy and one lipoma. Only 2 (28%) FNAs of lesions All patients with SELs 20 mm, 17 had resection/Imatinib, 25 underwent surveillance and two died of other causes. Conclusion EUS is a useful tool in the assessment, diagnosis and follow-up of small SELs. Management of lesions

Highlights

  • Trimethylamine N-oxide (TMAO) is formed in the liver from trimethylamine, and is exclusively generated by gut microbiota from the metabolism of dietary carnitine and choline

  • The Endobarrier is an endoscopically implanted duodenal jejunal bypass liner (DJBL) designed to mimic the effects of bariatric surgery leading to significant weight loss and improvements in glycaemic control and we present novel data of its effects on the plasma metabolic profile of these patients

  • Raised levels of Plasma TMAO have been associated with the development of diabetes and in this study were found to reduce following 6 months and 1 year of DJBL therapy compared with controls

Read more

Summary

Introduction

Trimethylamine N-oxide (TMAO) is formed in the liver from trimethylamine, and is exclusively generated by gut microbiota from the metabolism of dietary carnitine and choline. Elevated plasma levels have been implicated in the pathogenesis of Type 2 Diabetes and cardiovascular disease. Gastric subepithelial lesions (SEL) have a broad differential including malignant disease. Endoscopic ultrasound (EUS) ± fine needle aspiration (FNA) has become essential in assessing and managing SELs. The optimum assessment and follow-up strategy for lesions

Objectives
Methods
Findings
Conclusion
Full Text
Paper version not known

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.