Kallimanis G E, Gupta P K, al-Kawas F H, Tio L T, Benjamin S B, Bertagnolli M E, Nguyen C C, Gomes M N, Fleischer D E
Division of Gastroenterology, Georgetown University Medical Center, Washington, D.C. 20007-2197, USA.
Gastrointest Endosc. 1995 Jun;41(6):540-6. doi: 10.1016/s0016-5107(95)70187-7.
To fully evaluate patients with esophageal cancer by endoscopic ultrasonography (EUS), the transducer must pass through the entire tumor to the cardia to scan the celiac axis. Dilation may be necessary. Published information suggests that dilation with EUS carries a sizeable risk.
In order to assess the complication rate associated with dilation prior to EUS in patients with esophageal cancer and the clinical significance of dilation for complete EUS staging, we reviewed the records of all patients who had undergone EUS for esophageal cancer.
Sixty-three patients underwent EUS staging of esophageal cancer. Thirty-nine (62%) had lesions through which the EUS scope was passable (Group I). Ten (16%) patients (Group II) had lesions through which an EUS scope (diameter 13 mm) was unable to pass even after dilation. Fourteen patients (22%) had lesions that were dilated to allow passage of the EUS scope (Group III). All patients in Groups II and III had confirmation of EUS staging by CT and/or surgery. In Group II, five patients had tumors defined as T4 (50%) and five as T3 (50%). In Group III, nine (64%) had T4 tumors, four (29%) had T3, and one (7.7%) had T2. No complications were encountered in any group.
EUS, either alone or after dilation, is a safe procedure and the complete EUS examination with celiac node visualization adds prognostically significant information.
为了通过内镜超声检查（EUS）全面评估食管癌患者，换能器必须穿过整个肿瘤到达贲门以扫描腹腔干。可能需要进行扩张。已发表的信息表明，EUS引导下的扩张存在相当大的风险。
为了评估食管癌患者在EUS检查前进行扩张的并发症发生率以及扩张对完整EUS分期的临床意义，我们回顾了所有接受过食管癌EUS检查的患者的记录。
63例患者接受了食管癌的EUS分期。39例（62%）患者的病变部位EUS探头能够通过（I组）。10例（16%）患者（II组）的病变部位即使在扩张后，直径13mm的EUS探头仍无法通过。14例患者（22%）的病变部位进行了扩张以使EUS探头能够通过（III组）。II组和III组的所有患者均通过CT和/或手术确认了EUS分期。在II组中，5例患者的肿瘤被定义为T4（50%），5例为T3（50%）。在III组中，9例（64%）为T4肿瘤，4例（29%）为T3，1例（7.7%）为T2。所有组均未出现并发症。
单独使用EUS或扩张后使用EUS都是安全的操作，完整的EUS检查并观察腹腔淋巴结可提供具有预后意义的重要信息。
