BACKGROUND: American Gastroenterological Association guidelines recommend performing EUS to characterize subepithelial lesions (SELs) discovered on upper endoscopy (EGD), followed by surveillance if no high-risk features are identified. However, limited data are available on the impact of and compliance with surveillance recommendations. OBJECTIVE: To determine the natural history of SELs<30 mm in size evaluated by EUS and to determine the degree of patient compliance with surveillance recommendations. DESIGN: Prospective registry. SETTING: Two tertiary centers. PATIENTS: We studied 187 consecutive adult patients referred for EUS evaluation of foregut SELs. MAIN OUTCOME MEASUREMENTS: Proportion of patients in whom SELs change in size or echo-features and compliance with follow-up recommendations. RESULTS: Surveillance was recommended in 65 patients with hypoechoic SELs (44.6% women, age 59.5±13.2 years); of these, 29 (44.6%) underwent surveillance EUS as recommended and were followed for a median of 30 months (range, 12-105). During follow-up, 16 SELs (25%) increased in size, with a mean increase of 3.4±3.9 mm (range, 1-15). No changes in echo-texture of the SELs were observed. One patient was referred to surgery during follow-up (because of SEL growth>30 mm). LIMITATIONS: Short follow-up duration; compliance was a secondary aim. CONCLUSIONS: During a median follow-up of 30 months, growth in size was observed in 25% of small foregut SELs. However, change in size was minimal, and only 1 patient was referred for surgery based on surveillance EUS findings. Compliance with surveillance recommendations is poor, with fewer than 50% of patients undergoing surveillance EUS as recommended.
BACKGROUND: American Gastroenterological Association guidelines recommend performing EUS to characterize subepithelial lesions (SELs) discovered on upper endoscopy (EGD), followed by surveillance if no high-risk features are identified. However, limited data are available on the impact of and compliance with surveillance recommendations. OBJECTIVE: To determine the natural history of SELs<30 mm in size evaluated by EUS and to determine the degree of patient compliance with surveillance recommendations. DESIGN: Prospective registry. SETTING: Two tertiary centers. PATIENTS: We studied 187 consecutive adult patients referred for EUS evaluation of foregut SELs. MAIN OUTCOME MEASUREMENTS: Proportion of patients in whom SELs change in size or echo-features and compliance with follow-up recommendations. RESULTS: Surveillance was recommended in 65 patients with hypoechoic SELs (44.6% women, age 59.5±13.2 years); of these, 29 (44.6%) underwent surveillance EUS as recommended and were followed for a median of 30 months (range, 12-105). During follow-up, 16 SELs (25%) increased in size, with a mean increase of 3.4±3.9 mm (range, 1-15). No changes in echo-texture of the SELs were observed. One patient was referred to surgery during follow-up (because of SEL growth>30 mm). LIMITATIONS: Short follow-up duration; compliance was a secondary aim. CONCLUSIONS: During a median follow-up of 30 months, growth in size was observed in 25% of small foregut SELs. However, change in size was minimal, and only 1 patient was referred for surgery based on surveillance EUS findings. Compliance with surveillance recommendations is poor, with fewer than 50% of patients undergoing surveillance EUS as recommended.
Authors: Sébastien Godat; Maxime Robert; Fabrice Caillol; Erwan Bories; Christian Pesenti; Chiara De Cassan; Jean Philippe Ratone; Flora Poizat; Marc Giovannini Journal: United European Gastroenterol J Date: 2015-09-07 Impact factor: 4.623
Authors: Fauze Maluf-Filho; Joel Fernandez de Oliveira; Ernesto Quaresma Mendonça; Augusto Carbonari; Bruno Antônio Maciente; Bruno Chaves Salomão; Bruno Frederico Medrado; Carlos Marcelo Dotti; César Vivian Lopes; Cláudia Utsch Braga; Daniel Alencar M Dutra; Felipe Retes; Frank Nakao; Giovana Biasia de Sousa; Gustavo Andrade de Paulo; Jose Celso Ardengh; Juliana Bonfim Dos Santos; Luciana Moura Sampaio; Luciano Okawa; Lucio Rossini; Manoel Carlos de Brito Cardoso; Marco Antonio Ribeiro Camunha; Marcos Clarêncio; Marcos Eduardo Lera Dos Santos; Matheus Franco; Nutianne Camargo Schneider; Ramiro Mascarenhas; Rodrigo Roda; Sérgio Matuguma; Simone Guaraldi; Viviane Figueiredo Journal: Endosc Ultrasound Date: 2017 Nov-Dec Impact factor: 5.628
Authors: Christoph Schlag; Christoph Menzel; Manuela Götzberger; Simon Nennstiel; Peter Klare; Stefan Wagenpfeil; Roland M Schmid; Gregor Weirich; Stefan von Delius Journal: Endosc Int Open Date: 2017-03