Significance of Mini Probe Ultrasonography-assisted Endoscopic Therapy in Management of Gastrointestinal Submucosal Lesions / 胃肠病学

ABSTRACT

Background:Conventional gastrointestinal endoscopy is incapable of determining the deriving layers,size and nature of submucosal lesions,however,mini probe ultrasonography(MPS)is effective for mural stratification and determining the deriving layers and nature of lesions within gastrointestinal wall,and is considered to be an optimal examination for suspected submucosal tumors before endoscopic or surgical operation. Aims:To assess the diagnostic value of MPS for gastrointestinal submucosal lesions and the significance of MPS-assisted endoscopic therapy. Methods:A total of 69 patients with presumed gastrointestinal submucosal protruded lesions were retrospectively enrolled. All of them underwent MPS and then endoscopic therapy,such as cyst incision,high frequency electric snare resection,endoscopic mucosal resection and endoscopic submucosal dissection were performed according to the deriving layers,size and nature determined by MPS. The ultimate diagnosis was confirmed by histopathological examination. Results:In the 69 cases of lesions,MPS showed that 15 were derived from muscularis mucosa,40 from submucosa,and 14 from muscularis propria;10 of them were considered as cyst,18 were stromal tumor,8 were leiomyoma,6 were ectopic pancreas,15 were neuroendocrine tumor,and 12 were lipoma. Compared with pathological diagnosis,an overall coincidence rate of 91. 3%(63 / 69)was achieved by MPS. Conclusions:The accuracy rate of MPS is high for determining the deriving layers and nature of gastrointestinal submucosal protruded lesions prior to the attempting of endoscopic removal. It might be helpful for selecting treatment modalities for this kind of lesions.