TITLE

STAGING STRICTURED OESOPHAGEAL TUMOURS: HOW USEFUL IS THE OLYMPUS MH908 SLIM-PROBE?

AUTHOR(S)
Meenan, J.; Tsang, S.; Doig, L.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA111
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Optimal EUS staging of oesophageal cancer is not possible in up to 30% of patients due to strictures preventing passage of the scope. Such incomplete studies may result in inappropriate management plans. Potential solutions to this problem include stricture dilatation, the use of high frequency mini-probes or the passage of a wire guided slim-probe. Dilatation with subsequent passage of a large diameter standard echo-endoscope has been associated historically with significant perforation rates. Mini-probes, although yielding high resolution near field images are inadequate for full staging of larger tumours or more distant nodes. The Olympus MH908 slim-probe (diameter, 8 mm; 7.5 MHz, cone-tip) may be passed over a wire placed at gastroscopy and permits views of the mediastinum, celiac axis and other proximal structures. The aim of this study was to determine the usefulness and safely of the Olympus MH908 "slim-probe" in the staging of oesophageal carcinoma. Data were retrieved retrospectively from the EUS database of a single referral center where a "slim probe" was available from January 2001. Completion rates before and after the introduction of the MH908 were compared. It was not the practice of this unit to dilate strictures for diagnostic purposes. As only a single slim-probe was available, it was not available for use with all strictures. Between June 1998 and April 2002, 331 patients underwent 340 EUS examinations for oesophageal cancer (40% of all EUS indications). The completion rate prior to the introduction of the MH908 was 67.9% compared with 83.9% afterwards (p < 0.02). The completion rate for individual scopes were GFUM20/200, 73% and MH908, 92% respectively (p < 0.01). The Olympus MH908 "slim-probe" significantly improves the success rate for full EUS staging of oesophageal cancer. This wire-guided echoendoscope should be regarded as an important item of equipment in units with a significant referral base for oesophageal carcinoma.
ACCESSION #
9748045

 

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