Value of endoscopic ultrasonography in choice of endoscopic therapy strategies for submucosal tumors in upper gastrointestinal tract

Abstract

Objective To evaluate the diagnostic value of endoscopic uhrasonography （EUS） for submucosal tumors in upper gastrointestinal tract, and its influence on choice of endoscopic therapies. Methods A total of 82 submucosal tumors from upper gastrointestinal tract were examined by EUS, and treated by various endoscopic therapeutic techniques including fulguration with high frequency current （ FHFC）, endoscopic mucosal resection （EMR） and endoscopic band ligation according to origin, size and property of the lesion. The diagnoses of 58 resected samples were determined by routine pathological examination and immu- nohistochemistry. All patients were followed up with routine endoscopy and EUS. Results FHFC was applied in 26 lesions originated from muscularis mucosa, EMR was used in 17 flat lesions originated from muscularis mucosa, and endoscopic band ligation in 38 lesions from muscularis propria and 1 tumor from muscularis mucosa. The diagnostic accuracy of EUS was 91.4% （53/58）. Except for post-operative bleeding in 1 patient, no other complications were observed. A total of 79 cases were followed up for 3-24 months, and no recurrence was found. Conclusion EUS can display the origin and property of submucosal tumors in upper gastrointestinal tract and guide the selection of endoscopic therapy, which is effective and safe in treatment of submucosal tumor in upper gastrointestinal tract. Key words: Endoscopic ultrasonography; Submucosal tumor; Endoscopic therapy