title: Ultrasonic esophagoprobe for TNM staging of highly stenosing esophageal carcinoma.
abstract: 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.
authors.affiliation: Department of Endoscopic Surgery, University Hospital Eppendorf, Hamburg, Germany.
authors.forename: K F
authors.initials: KF
authors.lastname: Binmoeller
authors.forename: H
authors.initials: H
authors.lastname: Seifert
authors.forename: U
authors.initials: U
authors.lastname: Seitz
authors.forename: J R
authors.initials: JR
authors.lastname: Izbicki
authors.forename: M
authors.initials: M
authors.lastname: Kida
authors.forename: N
authors.initials: N
authors.lastname: Soehendra
mesh_terms: 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