关键词: 电子超声内镜；内镜黏膜下剥离术；内镜下黏膜切除术；内镜黏膜下挖除术；食管肿瘤

Abstract:

Objective   To study the roles of endoscopic ultrasonography combining with endoscopic mucosal resection, endoscopic submucosal dissection, endoscopic submucosal excavation and surgery in the treatment and diagnosis of esophageal mucosal and submucosal tumors.  Methods   A total of 120 lesions in 118 patients during the period between January 2010 and January 2012 were involved in the study.  Esophageal mucosal and submucosal tumors observed by conventional endoscopy were detected by EUS. EUS image findings were compared with endoscopic and surgical postoperative pathological results (including pathological type and origin) for statistical analysis of accuracy rates.  Results   According to the pathological results, the diagnostic accuracy rate of EUS image findings for mucosal tumors was 100% (16/16), the accuracy rate of EUS origin layer was 93.75% (15/16). The diagnostic accuracy rate of EUS image findings for submucosal tumors was 88.5% (92/104), the accuracy rate of EUS origin layer was 97.1% (101/104).  The total diagnostic accuracy was 90% (108/120) and the total EUS origin layer accuracy rate was 96.7% (116/120) in this study.  Conclusion   EUS is an accurate techinque for detecting the esophageal′s structure layers, determining the tumor origin and estimating the tumor biological behavior. Therefore EUS findings can be one of themost important keys for choosing the treatment methods of the lesions, expanding the endoscopic treatment indications and guiding the surgical operations. So it should be applied commonly and SMTs should be treated early with the help of EUS.