EUS-guided mucosectomy for gastrointestinal cancer.
BACKGROUND
the only way of improving prognosis and survival in gastrointestinal cancer is early diagnosis, with intramucosal localization as confirmed by endoscopic ultrasonography (EUS) or 20-MHz miniprobes (MPs) (T1) being most appropriate. Endoscopic mucosal resection (EMR) has proven effective in the treatment of this sort of lesions.


METHODS
in a group (18 cases) with 15 cases of superficial gastrointestinal cancer and 3 cases of severe gastric dysplasia, 9 cases (3 esophageal, 4 gastric, 2 rectal) underwent a classic EMR following EUS or a 7.5- and 20-MHz miniprobe exploration.


RESULTS
ultrasonographic studies showed a T1 in all but one esophageal case (Tis), and in both gastric dysplasias, with no changed layer structure being demonstrated in the latter (T0). No complications arose with classic EMR, and all 9 patients are alive and free from local or metastatic recurrence, except for one esophageal case, which recurred distally to the esophageal lesion (metachronous).


CONCLUSIONS
echoendoscopically-assisted EMR is a safe, effective technique in the endoscopic management of superficial gastrointestinal (esophageal, gastric, colorectal) cancer. Recurrence most likely depends upon cancer multiplicity.
Miquel
J M
JM
Echoendoscopy Unit, Centro Médico Delfos., A Coruña, Spain.
Abad
R
R
Souto
J
J
Fabra
R
R
Vila
M
M
Bargalló
D
D
Vázquez-Iglesia
J L
JL
Varas Lorenzo
M J
MJ
D000368:Aged; D000369:Aged, 80 and over; D013505:Digestive System Surgical Procedures; D016145:Endoscopy, Digestive System; D019160:Endosonography; D005260:Female; D005753:Gastric Mucosa / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007413:Intestinal Mucosa / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016896:Treatment Outcome