EUS-guided mucosectomy for gastrointestinal cancer

Abstract

Introduction: 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.Patients and method: 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.Key words: Superficial cancer (early cancer). Endoscopic ultrasonography. High-frequency miniprobes. Mucosectomy or endoscopic mucosal resection.Miquel JM, Abad R, Souto J, Fabra R, Vila M, Bargalló D, Vázquez-Iglesias JL, Varas Lorenzo MJ. EUS-guided mucosectomy for gastrointestinal cancer. Rev Esp Enferm Dig 2006; 98: 591-596.

Cirugía endoscópica transluminal por orificios naturales: NOTES

“…ERCP-mediated sphincterotomy, pancreatic pseudocyst drainage (2-10), mucosectomy (11) or endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), endoscopic muscular dissection (EMD), tumorectomy (12), and transanal endoscopic microsurgery (TEM) have been carried out via an endoscope introduced into the body through the mouth or anus, also aided by or under the guidance of endoscopic ultrasounds (EUS) ( Table II).…”