Rana Surinder S, Bhasin Deepak K, Singh Kartar
Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Ann Gastroenterol. 2011;24(4):280-284.
EUS, as it images the full thickness of the gastrointestinal tract wall, could provide more detailed information on benign esophageal strictures. Aim of this study was to evaluate the role of EUS in predicting the response to endoscopic dilatation in benign esophageal strictures.
27 patients with benign strictures (corrosive 14, peptic 10 & post-radiation 3) were prospectively studied with radial EUS.
The maximum esophageal wall thickness was significantly greater in patients with corrosive and post-radiation strictures in comparison to patients with peptic strictures. In patients with peptic stricture, the mucosal thickness involved either the mucosa (n=2) or submucosa (n=8) and in none of the patients was the muscularis propria involved. However, muscularis propria was involved in all 3 patients with post-radiation strictures and in 11/14 (78.5%) patients with corrosive strictures. Two peptic stricture patients with only mucosal thickening required a single session of dilatation whereas patients with involvement of submucosa required 2-4 sessions of dilatation. Patients with corrosive stricture having only involvement of submucosa required significantly fewer sessions in comparison to patients having muscularis propria involvement (2.67±0.58 vs. 6.30±1.16 sessions, respectively; p=0.0003).
EUS by delineating the extent of wall involvement in benign esophageal strictures predicts the response to endoscopic dilatation.
超声内镜（EUS）可对胃肠道壁全层进行成像，能够提供关于良性食管狭窄更详细的信息。本研究旨在评估EUS在预测良性食管狭窄内镜扩张疗效方面的作用。
对27例良性狭窄患者（腐蚀性狭窄14例、消化性狭窄10例、放疗后狭窄3例）进行前瞻性径向EUS研究。
与消化性狭窄患者相比，腐蚀性和放疗后狭窄患者的食管壁最大厚度显著更大。在消化性狭窄患者中，黏膜增厚累及黏膜层（2例）或黏膜下层（8例），无一例累及固有肌层。然而，3例放疗后狭窄患者及14例腐蚀性狭窄患者中的11例（78.5%）累及固有肌层。仅黏膜增厚的2例消化性狭窄患者需单次扩张，而黏膜下层受累的患者需2 - 4次扩张。与固有肌层受累的腐蚀性狭窄患者相比，仅黏膜下层受累的腐蚀性狭窄患者所需扩张次数显著更少（分别为2.67±0.58次和6.30±1.16次；p = 0.0003）。
EUS通过描绘良性食管狭窄壁受累范围可预测内镜扩张疗效。
