Increased rate of complete EUS staging of patients with esophageal cancer using the nonoptical, wire-guided echoendoscope☆,☆☆
Section snippets
PATIENTS AND METHODS
EUS examinations performed for esophageal cancer staging were reviewed. Patients with prior surgical resection, chemotherapy or radiotherapy were excluded. The remaining patients were divided into two groups. Group I consisted of patients whose EUS examinations were performed before the availability of the wire-guided echoendoscope (Olympus MH-908; Olympus America, Inc., Melville, N.Y.). These examinations were performed using the Olympus GF-UM20 echoendoscope (tip diameter 13.2 mm) between
RESULTS
There were 100 patients in group I and 30 in group II. The demographic characteristics of these two groups are summarized in Table 2.Empty Cell Group 1 Group 2 Empty Cell Empty Cell Before MH-908 (N = 100) After MH-908 (N = 30) Total (N = 130) Mean age (yr) (range) 64 (32-87) 63 (45-78) 64 (32-87) Gender (M/F) 81:19 23:7 104:26 Diagnosis Adenocarcinoma 68% 75% 69% Squamous cell carinoma 29% 25% 28% Undifferentiated carcinoma 2% 2% Small cell 1% 1%
DISCUSSION
Three methods have been proposed for the endosonographic evaluation of high-grade malignant esophageal strictures. The first involves the use of endoscopic dilation before EUS. This method is controversial. It has been reported to be safe by some investigators21 and associated with a prohibitively high rate (24%) of perforation by others.16 Although some endosonographers have also recommended the avoidance of dilation,10 others recommend sequential dilation over several days.3 We found the
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Reprint requests: Jacques Van Dam, MD, PhD, Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115.
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