Value Of Endoscopic Ultrasonograpy In Diagnosis And Treatment Of Submucosal Lesions

Objective:To evaluate the diagnostic and treatment value of endoscopic ultrasonography in gastric mucosal lesions.Methods:This study is based on 237 cases of gastric mucosal lesions in Qingdao University Medical College Hospital and Zibo NO.1 Hospital from March 2015 to March 2017.Endoscopic ultrasonography was performed to record the size and origin of the lesions and to make preliminary qualitative diagnosis of the lesions.Endoscopic resection of 186 cases,According to the actual lesion resection in endoscopic ultrasonography,judging the origin level of SMTs and the coincidence rate of endoscopic ultrasonography diagnosis According to the actual findings of pathological excision,we can determine the origin of SMTs and the coincidence rate of endoscopic ultrasonography.Pecimen pathology and immunohistochemistry was evaluated with the conformance rate of SMT diagnosed by endoscopic ultrasonography as gold standard.Results:1.Through endoscopic ultrasonography,186 patients were included in the study,96 males and 90 females aged 24 to 79 years,and the lesion size was 0.3*0.5-4.0*4.0cm.2.Endoscopic ultrasonography was used to estimate the origin of gastric mucosal lesions: 53 cases of mucosal muscle layer,24 cases of submucosa,109 cases of intrinsic muscle layer.Endoscopic resection was performed to estimate 45 cases of mucosal muscle layer,19 cases of submucosa,115 cases of intrinsic muscle layer,and 7 cases of serous membrane.3.There were 134 cases of qualitative diagnosis of endoscopic ultrasonography,41 cases of leiomyoma and 11 cases of ectopic pancreas.Through postoperative histopathologic examination,there were 110 cases of mesenchymal tumor,60 cases of leiomyoma,9 cases of ectopic pancreas,3 cases of inflammatory hyperplasia,3 cases of fibrous tumor,and 1 case of angioblastoma.4.Endoscopic ultrasonography qualitative diagnosis and endoscopic postoperative pathological diagnosis consistent total 133 cases,98 cases of interstitial tumor,31 cases of liomyoma,4 cases of ectopic pancreas,the total qualitative diagnosi s of gastric mucosal lesions was 71.51%(133/186).A total of 135 cases of consistent origin level diagnosis,33 cases of mucosa,6 cases of submucosa and 96 of the intrinsic muscle layer.Origin level judgment coincidence rate 72.58%(135/186).5.There were 34 cases of perforation,19 cases of active perforation and 15 cases of passive perforation,titanium clips and nylon rope was used to close the wound.,no late perforation cases.There were 31 cases of hemorrhage in intraoperative hemorrhage,all hemostasis with APC and titanium clips,and no delayed bleeding cases.Conclusion:1.Endoscopic ultrasonography has high localization,characterization and differential diagnosis value for gastric mucosal lesions.2.Diagnosis of gastric mucosal lesions under endoscopic ultrasonography is helpful for Choice of endoscopic resection surgical method.