Interobserver agreement for EUS in the evaluation and diagnosis of submucosal masses

Gress, Frank G.; Schmitt, Colleen M.; Savides, Thomas J.; Faigel, Douglas O.; Catalano, Marc F.; Wassef, Wahid; Roubein, Leor D.; Nickl, Nicholas; Ciaccia, D.; Bhutani, Manoop S.; Hoffman, Brenda J.; Affronti, John

doi:10.1067/mge.2001.111384

Cited by 109 publications

(85 citation statements)

References 18 publications

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“…It has also been used effectively to identify gastric submucosal tumors. The effectiveness of EUS has been demonstrated to be at best for leiomyomas and poor for other submucosal tumors [13] . However, the level of experience of the endosonographer is a critical factor, as greater experience is associated with a high degree of accuracy [13] .…”

Section: Diagnostic Evaluationmentioning

confidence: 99%

“…The effectiveness of EUS has been demonstrated to be at best for leiomyomas and poor for other submucosal tumors [13] . However, the level of experience of the endosonographer is a critical factor, as greater experience is associated with a high degree of accuracy [13] . EUS is imperative prior to laparoscopic gastric resection to objectivate the depth of wall invasion, and tumor expansion inside the gastric wall and to evaluate the local and regional lymph nodes.…”

Section: Diagnostic Evaluationmentioning

confidence: 99%

See 1 more Smart Citation

Laparoscopic-Endoscopic Rendezvous Resection of Upper Gastrointestinal Tumors

Schubert

Kuhn²,

Nestler³

et al. 2005

Dig Dis

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Background: Endoscopic and laparoscopic local resection of gastric tumors has increasingly been performed in recent years. This article describes the technical considerations and early results of laparoscopic-endoscopic rendezvous resection of gastric lesions. Patients and Methods: Rendezvous resection was performed in 26 patients with submucosal gastric tumors (n = 22) and early gastric cancer (n = 4). Laparoscopic wedge resection (LWR) was performed in 16 patients with anterior wall tumors and laparoscopic intragastric resection (LIR) in 7 patients with posterior wall tumors. Conversion to open surgery was carried out in 3 cases. Results: Operation times were 53 min (range 35–115) for LWR and 83 min (range 56–130) for LIR, respectively. In submucosal lesions the mean tumor size was 36 mm (range 16–47) and in early gastric cancer 17.3 mm (range 16–20). Rendezvous resection was performed with curative intent and clear resection margins in all patients without lymphatic or vessel permeation. Postoperative complications occurred in 2 patients. After a mean follow-up of 22.8 months (range 2–71), no local recurrence or metastatic disease and no tumor-related death were observed. Conclusions: When selected properly, the laparoscopic-endoscopic approach is considered to be curative and safe for resection of localized gastric tumors.

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Section: Diagnostic Evaluationmentioning

confidence: 99%

Section: Diagnostic Evaluationmentioning

confidence: 99%

Laparoscopic-Endoscopic Rendezvous Resection of Upper Gastrointestinal Tumors

Schubert

Kuhn²,

Nestler³

et al. 2005

Dig Dis

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show abstract

“…Firstly, Gress et al, described how the agreement factor, called k factor, in diagnosing sub-epithelial masses is lower (k=0.34) compared to the examination of superficial lesions (k=0.53-0.8). Additionally, the rate of disagreement were higher between low experienced endosonographers; therefore the lowest the number of EUS performed, the higher the discordance (Gress et al, 2001). At the same time, the Italian group, in the context of the staging of PGL of MALT type, found a fair agreement for T description (k=0.38) and substantial agreement in N definition (k=0.63).…”

Section: Endoscopic Ultrasound In Staging Of Diseasementioning

confidence: 70%

Role of the Endoscopic Ultrasonography in the Management of Gastric Lymphomas: Our Experience and Review of Literature

Vetro¹,

Romano²,

Palumbo³

et al. 2011

Ultrasound Imaging - Medical Applications

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“…If the lesion originates from the mucosal layer or submucosa layer, we give preference to endoscopic resection, such as high-frequency electric snare resection. Some esophageal leiomyomas originating from the muscularis propria may also be appropriate for endoscopic treatment, such as submucosal tunneling endoscopic resection (STER), endoscopic submucosal (8,9). If a lesion is difficult for endoscopic therapy, or the patient has obvious symptoms and require for treatment, or the endoscopic therapy was failed for the patient, surgery is preferred.…”

Section: Therapeutic Indicationsmentioning

confidence: 99%

Clinical value of endoscopic ultrasonography for esophageal leiomyoma in elder patients

Jiang

Chen

et al. 2017

J. Vis. Surg.

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Background: It's hard for conventional endoscopy to make a distinction between esophageal leiomyoma and submucosal lesions. The clinical features of elder patients with esophageal leiomyoma may be different with non-elder ones. This study examined the clinical value of endoscopic ultrasonography (EUS) in patients with esophageal leiomyoma, conclude the clinical characteristics of them, especially elder ones.Methods: During 2005-2015, 2,134 patients were diagnosed with esophageal leiomyoma by EUS, there are 249 elder patients (65 years and older) and 1,885 non-elder patients (under 65 years). We analyzed the clinical features, auxiliary examinations features, treatment outcomes and follow-up results of these patients, especially elder ones.Results: EUS were well tolerable in elder and non-elder patients. There was no difference in number, location, origin, size of lesions and in symptoms related esophageal leiomyoma between two groups. Elder patients had more positive changes in serological examinations. Preoperative diagnostic accuracy of EUS for esophageal leiomyoma was obviously superior to conventional endoscopy and computed tomography (CT).The misdiagnosis rate of malignant tumors was higher in elder ones. Fewer elder patients chose to be treated. Elder patients had higher complication incidence and hospitalization rate. During follow-up, most lesions showed no changes in patients without treatment, no recurrence in patients received treatments.Conclusions: Esophageal leiomyoma progresses slowly and has a benign course. EUS is of great value in patients with esophageal leiomyoma. The diagnosis and treatment of elder patients with esophageal leiomyoma are different with non-elder ones, and EUS can provide scientific and reasonable methods to manage elder patients. submucosal lesions or external pressure neoplasms, for it cannot acquire specific information of a lesion's size, origin, and the relationship with nearby organs, potentially causing diagnostic confusion (2). Keywords: Esophageal leiomyoma; endoscopic ultrasonography (EUS);Endoscopic ultrasonography (EUS) can clearly reveal the five-layered structure of the esophageal wall, and thereby confirm the nature, size, number, and origin of the lesions (3,5), and it is now an effective method of the diagnosis and treatment to esophageal leiomyomas.With the development and clinical application of EUS, the incidence of patients with esophageal leiomyomas is increasing, but there are few researches related were reported, especially in elder ones, whose diagnosis, differential diagnosis and treatment has its own particularity, so the clinical value of EUS in esophageal leiomyomas is worth further study.The purpose of this paper is to describe the EUS features, clinical features, auxiliary examinations features, treatment outcomes and follow-up results in patients with esophageal leiomyoma. Then concluded the clinical features of patients with esophageal leiomyoma, particularly in elder ones, investigating the diagnosis, differential diagnosis and treatment maki...

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Interobserver agreement for EUS in the evaluation and diagnosis of submucosal masses

Cited by 109 publications

References 18 publications

Laparoscopic-Endoscopic Rendezvous Resection of Upper Gastrointestinal Tumors

Laparoscopic-Endoscopic Rendezvous Resection of Upper Gastrointestinal Tumors

Role of the Endoscopic Ultrasonography in the Management of Gastric Lymphomas: Our Experience and Review of Literature

Clinical value of endoscopic ultrasonography for esophageal leiomyoma in elder patients

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