Endoscopy 2018; 50(04): S184
DOI: 10.1055/s-0038-1637601
ESGE Days 2018 ePosters
Georg Thieme Verlag KG Stuttgart · New York

RETROSPECTIVE COMPARISON OF THE RESULTS OF PREOPERATIVE RADIAL EUS WITH POSTOPERATIVE HISTOLOGY OF NON-EPITHELIAL TUMORS OF THE UPPER DIGESTIVE TRACT

E Gorbachev
1   N.I. Pirogov Russian National Research Medical University, Department of Abdominal Surgery, Surgical Gastroenterology and Endoscopy, Moscow University Hospital № 31, Moscow, Russian Federation
,
S Shapovalianz
1   N.I. Pirogov Russian National Research Medical University, Department of Abdominal Surgery, Surgical Gastroenterology and Endoscopy, Moscow University Hospital № 31, Moscow, Russian Federation
,
R Plakhov
1   N.I. Pirogov Russian National Research Medical University, Department of Abdominal Surgery, Surgical Gastroenterology and Endoscopy, Moscow University Hospital № 31, Moscow, Russian Federation
,
Z Galkova
1   N.I. Pirogov Russian National Research Medical University, Department of Abdominal Surgery, Surgical Gastroenterology and Endoscopy, Moscow University Hospital № 31, Moscow, Russian Federation
,
S Budzinskiy
1   N.I. Pirogov Russian National Research Medical University, Department of Abdominal Surgery, Surgical Gastroenterology and Endoscopy, Moscow University Hospital № 31, Moscow, Russian Federation
,
E Fedorov
1   N.I. Pirogov Russian National Research Medical University, Department of Abdominal Surgery, Surgical Gastroenterology and Endoscopy, Moscow University Hospital № 31, Moscow, Russian Federation
,
E Ernazarov
1   N.I. Pirogov Russian National Research Medical University, Department of Abdominal Surgery, Surgical Gastroenterology and Endoscopy, Moscow University Hospital № 31, Moscow, Russian Federation
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

There is no doubt that without performing EUS nobody would remove submucosal tumors (SMT) of the upper digestive tract (UGIT), while the importance of preoperative EUS-FNA is still debatable. How accurate radial EUS in predicting the morphological structure of SMT in routine clinical practice?

Methods:

From 1.01.1999 to 1.11.2017 we have operated 141 patients with SMT of the UGIT; EUS was performed in 122 out of them (m-27, f-95; ranged 26 – 80 years; mean age 59,4 ± 8,9 years). The location of SMT was the following: esophagus-12 (9.8%), stomach-102 (83.6%), duodenum-8 (6.6%). Data of preoperative EUS about types of tumor growth, structure and exact location of tumor allowed to execute of removal of tumor through endoscope in 61 (50.0%) patients (EMR-29, including 4 with laparoscopic assistance; ESD-23; STER-9). In 28 (23.0%) patients SMT was removed laparoscopically, including 7 with the da Vinci Surgical System and 33 (27.0%) SMT were removed via laparotomy.

Results:

The coincidence of EUS morphological pattern and postoperative histology in 105/122 (86.1%) patients were noted; certainly it was impossible precisely differentiate GIST and leiomyoma via radial EUS, without histological examination and immunohistochemistry. In 5/122 (4.1%) cases the morphology of SMT was not predicted in EUS report (postoperative histological conclusion: leiomyoma (2), GIST (1), hemangioma (1), mesenchyoma (1). In 12/122 (9.8%) patients, there was a discrepancy: in 5 cases instead of the predicted leiomyoma we found neurinoma (2), angiofibrolipoma (2) and neurofibrolipoma (1); in 2 cases instead of the predicted lipomas we found leiomyomas; in 5 other cases instead of the predicted neuroendocrine tumors (carcinoids) we found angiolipomas (2), angioleyomioma (1), inflammatory fibrotic polyp (1) and lipoma (1).

Conclusions:

Radial EUS, being the most important method of preoperative examination of patients with SMT allows to predict the rough morphological structure of the tumor in routine clinical practice with 86.1% accuracy, if we don't take into account the impossibility of a reliable differential diagnosis between GIST and leiomyoma without immunohistochemistry