Original Article
Application of preoperative endoscopic ultrasonography localization in adenocarcinoma of the esophagogastric junction
Xie Yongwei, Zhou Shunkai, Feng Xuegang, Lin Baoquan, Huang Yongpeng, Zhang Zaizhong, Wang Yu, Yang Shengsheng
Published 2019-10-25
Cite as Chin J Thorac Cardiovasc Surg, 2019, 35(10): 612-616. DOI: 10.3760/cma.j.issn.1001-4497.2019.10.008
Abstract
ObjectivePreliminary study on the clinical effect of preoperative ultrasound endoscopy combined with staining labeling technique to locate the actual boundary of esophageal and gastric cancer
MethodsFrom September 1, 2015 to October 30, 2017, 18 patients with esophageal adenocarcinoma were enrolled in this study. The actual boundaries of esophageal and gastric-derived adenocarcinoma lesions were localized by endoscopic ultrasonography and staining. There were 10 males and 8 females. After completing the preoperative examination, 1-2 days before operation, endoscopic ultrasonography was used to locate the edge of the lesion. Two point injection of carbon nano suspension was used to mark the location of 1cm at the longest distance from the longitudinal axis of the tumor. According to the length of longitudinal axial staining, the thoracotomy was performed. Intraoperative proximal margin resection was used to send frozen pathology. According to the results of freezing, the operation was decided. After the operation, the specimens from the margin of the tumor were segmented into paraffin section, which was about 0.5cm in each segment, and the tumor cells were observed under the electron microscope at all levels of the paraffin sections.
ResultsThe average time of preoperative endoscopic ultrasonography staining was(10.16±1.38) min, and the diameter of nano carbon diffusion was(1.43±0.41)cm. All patients in the operation could clearly see the nano carbon staining area under the naked eye. In the field, the average time of locating lesions was(1.27±0.53)min. 5 patients underwent thoracoabdominal surgery and 13 underwent abdominal surgery. The average length of the cut margin of the tumor was(4.74±1.12)cm, and the frozen pathology of the incision margin was negative, and no additional operation was performed. The routine pathology confirmed that all the specimens were negative.
ConclusionThe staining and labeling technique for adenocarcinoma of the esophagogastric junction under endoscopic ultrasonography can detect the tumor edge and the scope of invasion accurately. It provides guidance and guarantee for the smooth implementation of AEG precision surgery. It is a safe, rapid and effective positioning technique.
Key words:
Esophagogastric junction adenocarcinoma; Endoscopic ultrasonography; Carbon nano staining; Labeling technique, proximal margin
Contributor Information
Xie Yongwei
Department of Cardiothoracic Surgery, Fuzhou General Hospital, Fuzhou, Fujian 350025, China
Zhou Shunkai
Department of Cardiothoracic Surgery, Fuzhou General Hospital, Fuzhou, Fujian 350025, China
Feng Xuegang
Department of Cardiothoracic Surgery, Fuzhou General Hospital, Fuzhou, Fujian 350025, China
Lin Baoquan
Department of Cardiothoracic Surgery, Fuzhou General Hospital, Fuzhou, Fujian 350025, China
Huang Yongpeng
Department of Cardiothoracic Surgery, Fuzhou General Hospital, Fuzhou, Fujian 350025, China
Zhang Zaizhong
Department of General Surgery, Fuzhou General Hospital, Fuzhou, Fujian 350025, China
Wang Yu
Department of General Surgery, Fuzhou General Hospital, Fuzhou, Fujian 350025, China
Yang Shengsheng
Department of Cardiothoracic Surgery, Fuzhou General Hospital, Fuzhou, Fujian 350025, China
