Application of endoscopic ultrasound in the treatment of mesenchymal tumors of digestive tract by endoscopic submucosal dissection

Abstract

Abstract Background and purpose In cinical, some mesenchymal tumors of the digestive tract require endoscopic submucosal dissection (ESD). Endoscopic ultrasound (EUS) is required to evaluate tumor nature, size, and origin layer before ESD. The purpose of this study was to investigate the accuracy of EUS in evaluating the nature of tumors, and the relationship between tumor size, origin layer and ESD-related complications. Patients and Methods: All the 207 patients should undergo EUS before ESD. EUS should record the nature, location, origin layer and size of the tumor. ESD-related complications should also be recorded. Results In the 207 patients, EUS accurately identified the tumor nature of 158 (76.33%) patients. Thirty patients had perforation. Twenty-five (83.33%) patients occurred in stomach, 3 (10%) patients in esophagus, and 2 (6.67%) patients in rectum. The lesions of 28 (93.33%) perforated patients were located in muscularis propria under EUS, 2 (6.67%) patients were located in submucosa. In order to study the relationship between perforation and tumer size, 207 patients were divided into perforation group and non-perforation group. There was a significant difference in tumor size between the two groups (P = 0.047). A total of 11 patients had tumors larger than 20mm, 6 (54.55%) of them had perforation, and most of the perforated patients had tumors located in the muscularis propria. Conclusions The accuracy of EUS in evaluating mesenchymal tumors of the digestive tract is high. It is necessary to evaluate the layer and size of tumors by EUS before ESD.