Ultrasonic esophagoprobe for TNM staging of highly stenosing esophageal carcinoma.
BACKGROUND
Endosonographic staging of esophageal carcinoma may be limited in one third of cases by tumor stenoses that cannot be traversed with conventional echoendoscopes. We designed and evaluated a new endosonographic instrument (ultrasonic esophagoprobe) for TNM staging of highly stenosing esophageal carcinomas.


METHODS
Eighty-seven consecutive patients (64 men, mean age 61 years) with highly stenosing esophageal carcinomas were studied with the esophagoprobe (features: diameter of 7.9 mm, bougie-shaped tip, no fiber optics, insertion over a guide wire).


RESULTS
The esophagoprobe was successfully inserted past the stenosis without complication in all patients. Nine patients (10%) required preliminary bougienage to 33 F. The imaging quality was high and allowed for complete T and N staging in all patients. M staging was indeterminate in 15 patients because of inadequate visualization of the celiac axis region. Histopathologic correlation in 38 patients who underwent surgery showed an overall T stage accuracy rate of 89% (T2 = 80%, T3 = 95%, T4 = 87%), and N and M stage accuracies of 79% (N0 = 44%, N1 = 90%) and 91% (M0 = 94%, M1 = 75%), respectively.


CONCLUSIONS
The esophagoprobe enables safe passage of highly stenosing esophageal carcinomas for TNM staging. Accuracy rates are similar to those reported for conventional echoendoscopes.
Binmoeller
K F
KF
Department of Endoscopic Surgery, University Hospital Eppendorf, Hamburg, Germany.
Seifert
H
H
Seitz
U
U
Izbicki
J R
JR
Kida
M
M
Soehendra
N
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D004106:Dilatation; D004867:Equipment Design; D004938:Esophageal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D004940:Esophageal Stenosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D020701:Esophagoscopes; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D015203:Reproducibility of Results; D014463:Ultrasonography / Q000295:instrumentation / Q000379:methods