A retrospective study of 408 endoscopic ultrasound (EUS) exams for submucosal lesions

J. Affronti, C. Schmitt, F. Gress, M. F. Catalano, T. Savides, A. Chak, M. V. Sivak, W. Wassef, M. Bhutani, D. Faigel, N. Nicki, L. Roubein

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BACKGROUND: The interobserver variability within this multicenter group has been reported for EUS exams of submucosal lesions (SL). A standardized review of EUS exams for SL at each center was done to facilitate prospective studies underway. METHODS: Data from past consecutive EUS exams for SL at 9 participating centers was recorded on standard survey forms for each exam & collated. RESULTS: 408 EUS exams of patients with SL were studied. Median Age = 58 yrs. (range 14-91). 57% were male. SL were located in the esophagus (26%), GE junction (2%), stomach (61 %), duodenum (9%) & colon (2%). EUS images suggested the SL to be a stromal tumor in 23%, an extramural structure or normal anatomy in 21%, vascular in 10%, a lipoma in 8%, & cystic in 6%. No immediate complications were reported. The EUS exam was completed in 402 (98%). Incomplete exams were due to technical failure in 4, 1 poor preparation, & 1 uncooperative patient. The recommendation of the endoscopist after EUS was for no further work up in 165 (40%), surgery was recommended for 58 (14%), a follow up CT for 9 (2%), a CT guided biopsy for 1 (.2%), & a follow up EUS for 93 (23%). A specimen was obtained via EGD with deep foceps biopsy, &/or FNA, &/or surgery in 150 (36%). Evaluation of these specimens revealed a conclusive diagnosis in 106/150 (73%). CONCLUSIONS: After an EUS evaluation a substantial number of patients with SL were advised not to pursue any further workup and therefore avoided the associated expenses and risks. EUS is a safe method for evaluating SL. Additional prospective studies are merited to determine if EUS is a cost effective method for evaluating SL.

Original languageEnglish (US)
Pages (from-to)AB167
JournalGastrointestinal endoscopy
Issue number4
StatePublished - 1997
Externally publishedYes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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