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Published in: Surgical Endoscopy 4/2004

01-04-2004 | Original article

Impact of miniprobe ultrasonography on planning of minimally invasive surgery for gastric and colonic tumors

Authors: M. Hünerbein, T. Handke, C. Ulmer, P. M. Schlag

Published in: Surgical Endoscopy | Issue 4/2004

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Abstract

Background

The use of minimally invasive procedures for the management of gastrointestinal cancer is increasing. The aim of this study was to investigate the role of high-frequency miniprobe endoscopic ultrasound (EUS) for therapeutic decisions making in patients with gastric or colonic tumors.

Methods

A total of 137 patients underwent EUS with a 12.5-MHz miniprobe for preoperative staging of tumors of the stomach (n = 49) or colon (n = 88). After resection, the surgical path was reviewed to analyze the role of preoperative staging with miniprobes.

Results

Miniprobe EUS enabled accurate assessment of the infiltration depth of gastric and colonic tumors. The overall accuracy rates were 88% and 87%, respectively. The lymph node status was predicted correctly in 82% of the patients (sensivity, 61%, specificity, 94%). Based on the results of miniprobe EUS, patients with gastric cancer were accurately selected to undergo endoscopic mucosal resection, laparoscopic resection, or open surgery in 100%, 91%, and 86% of the cases, respectively. In patients with colonic tumors, the treatment decision analysis showed that the stratification was correct in 90% of the patients.

Conclusions

Miniprobe EUS is a reliable method for validating treatment decisions for patients undergoing minimally invasive procedures for gastric and colonic tumors. This method is particularly valuable in the management of colon cancer, because endoscopic and laparoscopic resections can be offered to selected patients as an alternative to open surgery.
Literature
1.
go back to reference Adachi, Y, Shiraishi, N, Kitano, S 2002Modern treatment of early gastric cancer: review of the Japanese experience.Dig Surg19333339CrossRefPubMed Adachi, Y, Shiraishi, N, Kitano, S 2002Modern treatment of early gastric cancer: review of the Japanese experience.Dig Surg19333339CrossRefPubMed
2.
go back to reference Akahoshi, K, Chijiiwa, Y, Sasaki, I 1998Pretreatment staging of endosonographically early gastric cancer with a 15MHz ultrasound catheter probe.Gastointest Endosc48470476 Akahoshi, K, Chijiiwa, Y, Sasaki, I 1998Pretreatment staging of endosonographically early gastric cancer with a 15MHz ultrasound catheter probe.Gastointest Endosc48470476
3.
go back to reference Cranley, JP, Petras, , RE, , Carey, WD 1986When is endoscopic polypectomy adequate therapy for colonic polyps containing invasive carcinoma?Gastroenterology91419427PubMed Cranley, JP, Petras, , RE, , Carey, WD 1986When is endoscopic polypectomy adequate therapy for colonic polyps containing invasive carcinoma?Gastroenterology91419427PubMed
4.
go back to reference Gervaz, P, Pikarsky, A, Utech, M, Secic, M, Efron, J, Belin, B, Jain, A, et al. 2001Converted laparoscopic colorectal surgery.Surg Endosc15827832CrossRefPubMed Gervaz, P, Pikarsky, A, Utech, M, Secic, M, Efron, J, Belin, B, Jain, A,  et al. 2001Converted laparoscopic colorectal surgery.Surg Endosc15827832CrossRefPubMed
5.
go back to reference Hamada, S, Akahoshi, K, Chijiiwa, Y, Sasaki, I, Nawata, H 1998Preoperative staging of colorectal cancer by a 15 MHz ultrasound miniprobe.Surgery123264269CrossRefPubMed Hamada, S, Akahoshi, K, Chijiiwa, Y, Sasaki, I, Nawata, H 1998Preoperative staging of colorectal cancer by a 15 MHz ultrasound miniprobe.Surgery123264269CrossRefPubMed
6.
go back to reference Harada, N, Hmada, S, Kubo, H, Oda, S, Chijiwa, Y, Kabemura, T, Maruoka, A, et al. 2001Preoperative evaluation of submucosal invasive colorectal cancer using a 15MHz ultrasound miniprobe.Endoscopy33237240CrossRefPubMed Harada, N, Hmada, S, Kubo, H, Oda, S, Chijiwa, Y, Kabemura, T, Maruoka, A,  et al. 2001Preoperative evaluation of submucosal invasive colorectal cancer using a 15MHz ultrasound miniprobe.Endoscopy33237240CrossRefPubMed
7.
go back to reference Hida, J, Yasutomi, M, Maruyama, T, Fujimoto, K, Uchida, T, Okuno, K 2003The extent of lymph node dissection for colon carcinoma: the potential impact on laparoscopic surgery.Cancer80188192CrossRef Hida, J, Yasutomi, M, Maruyama, T, Fujimoto, K, Uchida, T, Okuno, K 2003The extent of lymph node dissection for colon carcinoma: the potential impact on laparoscopic surgery.Cancer80188192CrossRef
8.
go back to reference Hünerbein, M, Totkas, S, Ghadimi, BM, Schlag, PM 2000Preoperative evaluation of colorectal neoplasms by colonoscopic miniprobe ultrasonography.Ann Surg2324650CrossRefPubMed Hünerbein, M, Totkas, S, Ghadimi, BM, Schlag, PM 2000Preoperative evaluation of colorectal neoplasms by colonoscopic miniprobe ultrasonography.Ann Surg2324650CrossRefPubMed
9.
go back to reference Japanese Gastric Cancer, Association 1998Japanese classification of gastric cancer.Gastric Cancer12434 Japanese Gastric Cancer, Association 1998Japanese classification of gastric cancer.Gastric Cancer12434
10.
go back to reference Kato, H, Haga, S, Endo, S, Hashimoto, M, Katsube, T, Oi, I, Aiba, M, et al. 2001Lifting lesions during endoscopic mucosal resection (EMR) of early colorectal cancer: implications for the assessment of resectability.Endoscopy33568573CrossRefPubMed Kato, H, Haga, S, Endo, S, Hashimoto, M, Katsube, T, Oi, I, Aiba, M,  et al. 2001Lifting lesions during endoscopic mucosal resection (EMR) of early colorectal cancer: implications for the assessment of resectability.Endoscopy33568573CrossRefPubMed
11.
go back to reference Lacy, AM, Garcia-Valdecasas, JC, Pique, JM, Delgado, S, Campo, E, Bordas, JM, Taura, P, et al. 1995Short-term outcome analysis of a randomized study comparing laparoscopic vs open colectomy for colon cancer.Surg Endosc911011105 Lacy, AM, Garcia-Valdecasas, JC, Pique, JM, Delgado, S, Campo, E, Bordas, JM, Taura, P,  et al. 1995Short-term outcome analysis of a randomized study comparing laparoscopic vs open colectomy for colon cancer.Surg Endosc911011105
12.
go back to reference Menzel, J, Domschke, W 2000Gastrointestinal miniprobe sonography: the current status.Am J Gastroenterol95605616CrossRefPubMed Menzel, J, Domschke, W 2000Gastrointestinal miniprobe sonography: the current status.Am J Gastroenterol95605616CrossRefPubMed
13.
go back to reference Milsom, JW, Bohm, B, Hammerhofer, KA, Fazio, V, Steiger, E, Elson, P 1998A prospective, randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report.J Am Coll Surg1874654PubMed Milsom, JW, Bohm, B, Hammerhofer, KA, Fazio, V, Steiger, E, Elson, P 1998A prospective, randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report.J Am Coll Surg1874654PubMed
14.
go back to reference Murata, N, Suzuki, S, Mitsunaga, A 1998Endoscopic ultrasonography in diagnosis and mucosal resection for early esophageal cancer.Endoscopy304446 Murata, N, Suzuki, S, Mitsunaga, A 1998Endoscopic ultrasonography in diagnosis and mucosal resection for early esophageal cancer.Endoscopy304446
15.
go back to reference Ohgami, M, Otani, Y, Kumai, K, Kubota, T, Kim, YI, Kitajima, M 1999Curative laparoscopic surgery for early gastric cancer: five years experience.World J Surg23187192PubMed Ohgami, M, Otani, Y, Kumai, K, Kubota, T, Kim, YI, Kitajima, M 1999Curative laparoscopic surgery for early gastric cancer: five years experience.World J Surg23187192PubMed
16.
go back to reference Silecchia, G, Perrotta, N, Giraudo, G, Salval, M, Parini, U, Feliciotti, F, Lezoche, E, et al. 2002Abdominal wall recurrences after colorectal resection for cancer: results of the Italian registry of laparoscopic colorectal surgery.Dis Colon Rectum4511721177PubMed Silecchia, G, Perrotta, N, Giraudo, G, Salval, M, Parini, U, Feliciotti, F, Lezoche, E,  et al. 2002Abdominal wall recurrences after colorectal resection for cancer: results of the Italian registry of laparoscopic colorectal surgery.Dis Colon Rectum4511721177PubMed
17.
go back to reference Tseng, LJ, Jao, YT, Mo, LR 2002Preoperative staging of colorectal cancer with a balloon-sheated miniprobe.Endoscopy34564568CrossRefPubMed Tseng, LJ, Jao, YT, Mo, LR 2002Preoperative staging of colorectal cancer with a balloon-sheated miniprobe.Endoscopy34564568CrossRefPubMed
18.
go back to reference Vukasin, P, Ortega, AE, Greene, FL, Steele, GD, Simons, AJ, Anthone, GJ, Weston, LA, et al. 1996Wound recurrence following laparoscopic colon cancer resection.Dis Colon Rectum39S20S23PubMed Vukasin, P, Ortega, AE, Greene, FL, Steele, GD, Simons, AJ, Anthone, GJ, Weston, LA,  et al. 1996Wound recurrence following laparoscopic colon cancer resection.Dis Colon Rectum39S20S23PubMed
19.
go back to reference Wexner, SD, Cohen, SM 1995Port site metastases after laparoscopic colorectal surgery for cure of malignancy.Br J Surg82295298PubMed Wexner, SD, Cohen, SM 1995Port site metastases after laparoscopic colorectal surgery for cure of malignancy.Br J Surg82295298PubMed
20.
go back to reference Yanai., H, Fujimura, H, Suzumi, M, Matsuura, S, Awaya, N, Noguchi, T, Karita, M, et al. 1993Delineation of the gastric muscularis mucosae and assessment of depth of invasion of early gastric cancer using a 20-megahertz endoscopic ultrasound probe.Gastrointest Endosc39505512PubMed Yanai., H, Fujimura, H, Suzumi, M, Matsuura, S, Awaya, N, Noguchi, T, Karita, M,  et al. 1993Delineation of the gastric muscularis mucosae and assessment of depth of invasion of early gastric cancer using a 20-megahertz endoscopic ultrasound probe.Gastrointest Endosc39505512PubMed
21.
go back to reference Yanai, H, Yoshida, T, Harada, T, Matsumoto, Y, Nishiaki, M, Shigemitsu, T, Tada, M, et al. 1996Endoscopic ultrasonography of superficial esophageal cancers using a thin ultrasound probe system equipped with switchable radial and linear scanning modes.Gastrointest Endosc44578582PubMed Yanai, H, Yoshida, T, Harada, T, Matsumoto, Y, Nishiaki, M, Shigemitsu, T, Tada, M,  et al. 1996Endoscopic ultrasonography of superficial esophageal cancers using a thin ultrasound probe system equipped with switchable radial and linear scanning modes.Gastrointest Endosc44578582PubMed
22.
go back to reference Yong, L, Deane, M, Monson, JR, Darzi, A 2001Systematic review of laparoscopic surgery for colorectal malignancy.Surg Endosc1514311439PubMed Yong, L, Deane, M, Monson, JR, Darzi, A 2001Systematic review of laparoscopic surgery for colorectal malignancy.Surg Endosc1514311439PubMed
Metadata
Title
Impact of miniprobe ultrasonography on planning of minimally invasive surgery for gastric and colonic tumors
Authors
M. Hünerbein
T. Handke
C. Ulmer
P. M. Schlag
Publication date
01-04-2004
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 4/2004
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-003-8925-z

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