The Application Of Endoscopic Ultrasound And Endoscopic Submucosal Dissection In Diagnosis And Treatment Of Esophageal Hemangioma

Objective:To evaluate the feasibility and efficacy of endoscopic ultrasound(EUS),and compared with gastroscopy and pathological diagnosis for the standard,to compare both the accuracy in diagnosis of esophageal hemangioma,and according to the characteristics of the Endoscopic ultrasonography examination,choose the Endoscopic submucosal dissection(Endoscopic submucosal dissection,ESD)treatment effect,provide the basis for clinical diagnosis and treatment.Methods:Choosing the sample during September 2010 to October 2015,which has got common gastroscopy with suspected esophageal hemangioma,and in the first affiliated hospital of zhejiang university and shengzhou city people's hospital endoscopy center line EUS examination,EUS diagnosis of esophageal hemangioma were in the first affiliated hospital of zhejiang university after endoscopy center line ESD endoscopic therapy and patients with pathological diagnosis,the endoscopic diagnosis and EUS diagnosis.Comparing the results with the final pathologic diagnosis analysis for esophageal hemangioma common gastroscope and diagnostic accuracy of EUS if there is a difference.Based on the characteristics of the origin,size,boundary,evenness and echo range of the lesion,the ESD endoscopic therapy was selected,and the complications were recorded and the postoperative complications were recorded.The EUS characteristics,clinical features,complete removal rate,complication rate and recurrence rate of esophageal hemangioma were recorded.Results:1?The results of EUS in the diagnosis of esophageal hemangioma:(1)the part of the esophagus hemangioma:29 cases of suspected common gastroscopy,endoscopic ultrasonography in the diagnosis of 19 cases,16 cases of pathological diagnosis of esophageal hemangioma,6 cases in esophagus,9 cases with middle and 1 case under paragraphs.(2)the EUS features of esophageal hemangioma:low-echoic mass,clear boundary,homogeneous or uneven internal echo,both from submucosal layer.2?EUS and endoscopy were accurate in diagnosis of esophageal hemangioma:the total accuracy of EUS was 84.2%,and the total accuracy of the gastroscope was 55.1%.EUS in the diagnosis of conform to the total number of cases and gastroscope diagnosis accord with the total number of cases of statistical analysis,there is a very significant statistical differences(P<0.05),for esophageal hemangioma,endoscopic ultrasonography in the diagnosis of significantly better than that of gastroscope.3.Esophagus endoscopic treatment of hemangioma:according to patients with preoperative told the advantages of various treatments and related risk,combining with the characteristics of patients with lesions,the patient and the family will eventually accept line ESD patients a total of 19,ESD treatment complete resection rate was 100%,there are 7 cases intraoperative bleeding,both in the CLP coagulation or hemostatic forceps hemostasis,no intraoperative took place the perforation,did not occur late postoperative bleeding and perforation.No recurrence was found during post-discharge follow-up.Conclusion:1.Ultrasonic endoscopy can provide the characteristics of the origin,size,boundary,evenness and echo focal lesions of the echo.For esophageal hemangioma,ultrasound endoscopic diagnosis is significantly better than that of gastroscope.2.Esophageal hemangioma is a rare lesion with multiple hair in the esophagus.3.Esophageal hemangioma can clearly define the scope and depth of the lesion after EUS examination and guide ESD treatment.ESD resection of esophageal hemangioma is a safe and effective minimally invasive treatment.