Preoperative Staging of Esophageal Carcinoma: Miniprobe Sonography Versus Conventional Endoscopic Ultrasound in a Prospective Histopathologically Verified Study

Menzel, J.; Hoepffner, N.; Nottberg, H; Schulz, Christin; Senninger, N.; Domschke, W

doi:10.1055/s-1999-12

Cited by 86 publications

(40 citation statements)

References 17 publications

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“…Furthermore, the large diameter of the echoendoscope (1.2 cm) may prevent complete staging of stenotic tumors [17]. Recently, high-resolution miniprobes with 12.5-20 MHz have been developed that may help to overcome some of the problems encountered with conventional endosonography [4,8,11,16]. This study was performed to investigate the impact of endosonography on demand with miniprobes and conventional EUS on the staging of upper GI tumors.…”

mentioning

confidence: 99%

Endosonography of upper gastrointestinal tract cancer on demand using miniprobes or endoscopic ultrasound

et al. 2003

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mentioning

confidence: 99%

Endosonography of upper gastrointestinal tract cancer on demand using miniprobes or endoscopic ultrasound

et al. 2003

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“…14,15 Compared with other imaging modalities such as computed tomography, EUS is superior in staging of esophageal tumors because of its higher spatial resolution, which allows to differentiate the esophageal wall layers. 16,17 Using EUS, the aim of this study was to investigate the more subtle changes of and injuries to the posterior wall of the left atrium, the periesophageal connective tissue, and the whole wall of the esophagus including mucosal alterations.…”

Section: Clinical Perspective On P 159mentioning

confidence: 99%

Damage to the Esophagus After Atrial Fibrillation Ablation

Zellerhoff¹,

Ullerich²,

Lenze³

et al. 2010

Circ: Arrhythmia and Electrophysiology

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Background-Radiofrequency catheter ablation is increasingly used in the treatment of atrial fibrillation. Esophageal wall changes varying from erythema to ulcers have been described by endoscopy in up to 47% of patients following pulmonary vein isolation (PVI). Although esophageal changes are frequently reported, the development of a left atrial (LA)-esophageal fistula is fortunately rare. Nevertheless, mucosal changes may just represent "the tip of the iceberg." The aim of this study was, therefore, to investigate the more subtle changes of and injuries to the posterior wall of the LA, the periesophageal and mediastinal connective tissue, and the whole wall of the esophagus, including mucosal changes by esophagogastroduodenoscopy (EGD) combined with radial endosonography (EUS). Methods and Results-Twenty-nine patients (7 females; mean age, 57.7Ϯ10.5 years [range, 23-75 years]) underwent EGD and EUS before and after PVI within 48 hours. PVI was performed as a circumferential antral isolation of the septal and lateral pulmonary veins guided by a decapolar circular mapping catheter using a 3-dimensional mapping system with the integration of a preprocedurally acquired computed tomography scan of the left atrium. The maximum power applied was 30 W, with an open-irrigated catheter using a maximum flow rate of 30 mL/min. In all patients, the esophagus was reconstructed using the same computed tomography scan and displayed during the ablation procedure. In case of newly detected periesophageal changes, EGD and EUS were repeated 1 week after the PVI. In all patients, a regular contact area between the LA and the esophagus could be demonstrated before PVI. The mean vertical contact length was 4.4Ϯ1.5 cm (range, 2-10 cm); and the mean distance between the anterior wall of the esophagus and the endocardium was 2.6Ϯ0.8 mm (range, 1.4 -4.0 mm). After PVI, morphological changes of the periesophageal connective tissue and the posterior wall of the LA were diagnosed by endosonography in 8 patients (27%; 95% confidence interval, 12.73-47.24). No mucosal changes of the esophagus in terms of erythema or ulcers were found. In all but one patient (who refused the control), all periesophageal and atrial changes had resolved within 1 week. No atrioesophageal fistula occurred during follow-up (mean follow-up, 294Ϯ110 days [range, 36 -431 days]). Conclusions-Mucosal changes of the esophagus after PVI-like ulcers or erythema could not be demonstrated, yet structural changes of the mediastinum, which were only visible by endosonography, occurred in 27% of patients in the present study. This may indicate a higher than expected periesophageal injury because of PV ablation. Endosonography might prove to be a sensitive and reliable tool in the follow-up after PVI. (Circ Arrhythm Electrophysiol. 2010;3:155-159.)

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“…The proportion of tumors which are non-traversable varies from study to study, but may be up to 45 % [19,48,49]. Most non-traversable tumors are at least T3 tumors.…”

Section: Obstructing Tumors: What Are the Options For Eus Staging?mentioning

confidence: 99%

“…However, the miniprobes' high frequency may limit their ability to evaluate the full depth of tumor penetration and regional lymph node involvement. Nonetheless, at least one study has shown better T staging and comparable N staging with miniprobe EUS compared to conventional EUS in patients with both traversable and non-traversable tumors [48].…”

Section: Obstructing Tumors: What Are the Options For Eus Staging?mentioning

confidence: 99%

Esophageal Cancer

Khanna¹,

Lightdale²

2015

ERCP and EUS

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Preoperative Staging of Esophageal Carcinoma: Miniprobe Sonography Versus Conventional Endoscopic Ultrasound in a Prospective Histopathologically Verified Study

Cited by 86 publications

References 17 publications

Endosonography of upper gastrointestinal tract cancer on demand using miniprobes or endoscopic ultrasound

Endosonography of upper gastrointestinal tract cancer on demand using miniprobes or endoscopic ultrasound

Damage to the Esophagus After Atrial Fibrillation Ablation

Esophageal Cancer

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