Combined EUS and CT for evaluating gastrointestinal submucosal tumors before endoscopic resection.

Goals: The aim of this study was to evaluate the combination of endoscopic ultrasonography (EUS) and computed tomography (CT) in predicting the maneuvers for therapeutic endoscopy for gastrointestinal submucosal tumors (SMTs).

Methods: Patients with SMTs, who were scheduled for endoscopic resection, were randomized to preoperative performance of both EUS and CT (group A) or EUS only (group B). The following data were collected: therapeutic maneuvers, duration of procedure, dose of propofol, resected lesion size, and complications.

Results: A total of 36 patients were included in group A and 36 patients were included in group B. Endoscopic submucosal excavation was performed in 43 patients, endoscopic full-thickness resection in 18 patients, and submucosal tunneling endoscopic resection in 11 patients. No significant differences were observed between the two groups (P>0.05). The coincidence rate between the preoperative program and the actual endoscopic procedures in group A was higher than that in group B (83.3 vs. 61.1%, P<0.05). The procedural time in group A was less than that in group B (39.36±17.83 vs. 48.06±12.03 min, P<0.05), and the dose of propofol in group A was less than that in group B (249.18±125.12 vs. 304.16±102.61 mg, P<0.05). The mean resected lesion size was 2.32±1.46 cm in group A and 2.12±0.75 cm in group B, without differences (P>0.05). A total of 14 cardiopulmonary complications and seven endoscopic complications occurred, without significant differences between the two groups (P>0.05).

Conclusion: EUS combined with CT can better evaluate SMTs compared with EUS only in predicting the maneuvers for therapeutic endoscopy.