Ultrasonido endoscópico Utilidad en neoplasias de vías digestivas Aplicaciones en mediastino Otras Aplicaciones
1. Ultrasonido endoscópico Utilidad en neoplasias de vías digestivas Aplicaciones en mediastino Otras Aplicaciones Leonardo SOSA VALENCIA MD MMS Centro de Investigaciones Tecnológicas Ecoendoscópicas CITE Caracas-Valencia-Barquisimeto-Puerto Ordaz-Maturín
18. Rosch T. Endosonographic staging of esophageal: a review of literature results. Gastrointest Endosc Clin North Am 1995; 5:537-547
19. Vazquez-Sequeiros. Impact of lymph node staging on therapy of esophageal carcinoma. Gastroenterology 2003; 12:1626-1635
20. Shows the accuracy of EUS with confidence intervals to diagnose T stages in ECA patients. Srinivas R. et al T Staging Accuracy of Esophageal Cancers By Endoscopic Ultrasound: A Meta-Analysis and Systematic Review G astrointestinal Endoscopy , Volume 65, Issue 5 , April 2007 , Page AB362 389 estudios relevantes : 36 artículos. N:2558 250.0 (145.2-430.5) 0.1 (0.1-0.2) 25.4 (13.7-47.0) 97.4% (96.6-98.0) 92.4% (89.2-95.0) T4 145.2 (90.3-233.4) 0.1 (0.1-0.2) 12.5 (7.7-20.3) 94.4% (93.1-95.5) 91.4% (89.5-93.0) T3 90.7 (48.3-170.5) 0.2 (0.2-0.3) 16.6 (9.3-29.7) 96.3% (95.4-97.1) 81.4% (77.5-84.8) T2 221.5 (118.5-413.9) 0.2 (0.2-0.4) 44.4 (15.5-127.4) 99.4% (99.0-99.7) 81.6% (77.8-84.9) T1 Pooled DOR Pooled LR− Pooled LR+ Pooled specificity Pooled sensitivity
21. Srinivas R. Puli, Jyotsna Reddy, Matthew Gastrointestinal Endoscopy Volume 65, Issue 5 , April 2007, Page AB191 The Influence of Advancing Technology in Endoscopic Ultrasound On the Accuracy of Nodal Staging in Esophageal Cancers: A Meta-Analysis and Systematic Review 360 artículos relevantes: 44 estudios. N:4398 14.9 (6.7-33.1) 0.3 (0.2-0.4) 3.4 (2.2-5.3) 82.4% (78.2-86.1) 81.6% (77.8-85.1) 10 1995 to 1999 2000 to 2005 14.8 (7.5-29.3) 0.3 (0.2-0.4) 3.0 (2.1-4.5) 84.4% (81.6-86.9) 82.6% (78.0-85.9) 17 1995 to 1999 27.6 (14.6-52.4) 0.2 (0.1-0.3) 3.6 (2.4-5.4) 85.2% (83.4-86.9) 88.0% (85.4-90.2) 17 1986 to 1994 Pooled diagnostic odds ratio Pooled negative likelihood ratio Pooled positive likelihood ratio Pooled specificity Pooled sensitivity No of studies Time period
22. Pooled diagnostic accuracy estimates of EUS for different time periods with 95% confidence intervals Has Improvement in Endoscopic Ultrasounds' Technology Over the Last 20 Years Enhanced It's Ability to Diagnose Distal Metastasis of Esophageal Cancers? : A Meta-Analysis and Systematic Review Srinivas R. Puli, Jyotsna B.k. Reddy Gastrointestinal Endoscopy 65, Issue 5 , April 2007, 346 artículos relevantes. 24 estudios. N:2029 99.6 (40.5-245.1) 0.3 (0.2-0.4) 24.3 (11.9-49.5) 98.0% (95.7-99.3) 77.2% (66.4-85.9) 4 2000 to 2006 67.8 (23.5-195.7) 0.3 (0.1-0.6) 15.2 (6.1-37.5) 97.7% (96.6-98.6) 76.6% (70.1-82.3) 13 1995 to 1999 67.8 (17.9-257.7) 0.4 (0.2-0.6) 20.2 (7.1-57.9) 98.3% (96.0-99.4) 59.1% (49.6-68.2) 7 1986 to 1994 Pooled diagnostic odds ratio Pooled negative likelihood ratio Pooled positive likelihood ratio Pooled specificity Pooled sensitivity No of studies Time period
52. Paul De Leyn. ESTS guidelines for preoperative lymph node staging for non-small cell lung cancer. European Journal of Cardio-thoracic surgery. 32 (2007)1-8
53. Paul De Leyn. ESTS guidelines for preoperative lymph node staging for non-small cell lung cancer. European Journal of Cardio-thoracic surgery. 32 (2007)1-8
La ecoendoscopia logra detectar ascitis escasa, metatstasis peritoneales y epiploicas al igual que invasión a la trasncavidad de los epiplones, todos signos indirectos de enfermedad avanzada. Por últimos logra evaluar parcialmente el hígado detectando metástasis inferiores a los 15mm, con la posibilidad siempre de biopsiarlas a través de la pared anterior del estómago sin complicaciones importantes.
El seguimiento de los pacientes operados con un procedimiento de Whipple o una pancreatectomía izquierda se realiza en muchos centros sin embargo no ha demostrados aún verdaderos beneficios.
Otras lesiones como el cáncer gástrico, tanto adenocarcinoma como linfoma y maltoma son indicaciones de T y N preterapéutico, el colangiocarcionma o su sospecha y la presencia de adenomegalias digestivas sin causa identificada. El carcinoma de vesícula biliar en presencia de macrolitiasis podría ser subclasificado y no detectado.
