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Sakio H, Yamaguchi Y
Nihon Kyobu Geka Gakkai Zasshi. 1989 Apr
PMID:2671193
Abstract
The resectability of primary lung cancer depends on the extent of invasion to the mediastinum. To evaluate whether transesophageal endoscopic ultrasonography (E-EUS) could detect mediastinal invasion of lung cancer or not, this method was applied in 22 lung cancer cases in which mediastinal invasion was suspected on the basis of the chest roentgenogram and/or CT scan. An ultrasonic probe with a 5 MHz linear array transducer, 12 mm in diameter and 40 mm in length was attached to the tip of an esophagofiberscope for this study. Ultrasonographic findings were classified into four grades, grade 0; existence of a hyperechoic area between the tumor mass and the mediastinum, grade I; tumor mass in direct contact with mediastinum which appears to be normal in structure accompanied by movement of tumor mass on respiration, grade II; partial disappearance of laminar structures and changes in the mediastinal wall, with no movement of the tumor mass relative to the mediastinum, grade III; tumor invasion within the lumen of the mediastinum. Organs contained by the mediastinum include the pulmonary arteries, aorta, left atrium, pulmonary veins, superior vena cava (SVC) and the esophagus were clearly visualized in detail as real-time images, therefore more detailed information about changes in the laminar structures of walls could be obtained. The sensitivity, specificity and accuracy of E-EUS were 77.8%, 81.8% and 80.0%, respectively. E-EUS could detect mediastinal invasion more accurately than chest roentgenogram, CT or MRI. Particularly, in the SVC, descending aorta and esophagus, the longitudinal extent of tumor can be analyzed accurately. These results suggest that E-EUS can be useful to assess resectability and also to decide the surgical margin preoperatively in case of primary lung cancer in which mediastinal involvement is considered.
Takase Y, Ozaki A, Orii K, Nagoshi K, Okamura T
Surgery. 1982 Sep
PMID:6981219
Abstract
From October 1977 to September 1981, 68 patients with esophageal varices (30 emergency cases of bleeding and 38 elective cases) were treated by injecting 5% ethanolamine oleate into varices, using an esophagofiberscope. Esophageal bleeding was successfully controlled in 29 of 30 patients who had emergency surgery. None of the 38 patients who underwent elective operation had bleeding after treatment. When recurrence occurred 1 or 2 years after treatment, the same procedure was repeated. Pleuritis occurred in one of the patients who had emergency surgery, and bleeding (300 to 400 ml) from the esophagocardial junction occurred in two patients who underwent elective operation. These patients were treatment conservatively.
Miwa T, Sakita T
Gastrointest Endosc. 1972 Nov
PMID:4648829
Abstract