Bruno Marco J
Department of Gastroenterology & Hepatology, Erasmus Medical Centre, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Dig Endosc. 2017 May;29(4):503-511. doi: 10.1111/den.12842. Epub 2017 Mar 20.
Endoscopic ultrasonography (EUS) is an essential endoscopic tool within the diagnostic and therapeutic armamentarium of gastrointestinal and hepatic diseases. EUS-guided tissue acquisition will develop towards facilitating personalized treatment by obtaining large representative tissue specimens for elaborate immunohistochemical and biomolecular typing of the tumor. Intratumoral or intravascular delivery of drugs potentially offers many advantages over systemic injection. Intratumoral application of radiofrequency ablation and photodynamic therapy show promise but need to be explored further. Appositioning and connecting luminal structures within the gastrointestinal tract using fully covered expandable lumen-apposing stents will expand its indication far beyond the drainage of (infected) fluid collections and EUS-guided gastrojejunostomy is a particularly exciting development that could have significant impact on the management of gastric outlet obstruction.
内镜超声检查（EUS）是胃肠道和肝脏疾病诊断与治疗手段中的一种重要内镜工具。EUS引导下的组织获取将朝着通过获取大量具有代表性的组织标本以进行肿瘤精细免疫组化和生物分子分型来促进个性化治疗的方向发展。肿瘤内或血管内给药相较于全身注射可能具有诸多优势。肿瘤内应用射频消融和光动力疗法显示出前景，但仍需进一步探索。使用全覆膜可扩张管腔贴附支架对胃肠道内的管腔结构进行贴附与连接，将使其适应证远远超出（感染性）液体积聚的引流范围，并且EUS引导下胃空肠吻合术是一项特别令人兴奋的进展，可能会对胃出口梗阻的治疗产生重大影响。
