EUS in the Management of High-Risk Gastrointestinal Precancerous Lesions before Endoscopic Resection

Aim: To investigate the evaluation of EUS for the high-risk gastrointestinal precancerous lesions (HRGIPCL) before endoscopic resection. Methods: The patients with HRGIPCL scheduled for endoscopic resection, were randomized to preoperatively performing EUS (Group A) versus without EUS (Group B). Data were prospectively collected as follows: routine endoscopic results, EUS findings, therapeutic maneuvers, resected lesion size, final diagnosis and the grades of therapeutic maneuvers. Results: 116 patients with 156 HRGIPCL were included in Group A and 116 with 140 HRGIPCL in Group B. In terms of routine endoscopic results, resected lesion size (1.84 ± 1.30cm in Group A vs 1.70 ± 0.97cm in Group B) and final diagnosis, no differences were found between two groups (P >0.05). 207 endoscopic mucosal resection (EMR) was performed for 157 patients (114 EMR for 81 patients in Group A vs 93 for 76 in Group B), 14 endoscopic piecemeal mucosal resection (EPMR) for 14 patients (7 in Group A vs 7 in Group B), and 72 endoscopic submucosa dissection (ESD) for 67 patients (32 ESD for 30 patients in Group A vs 40 for 37 in Group B). No significant differences were observed between two groups (P >0.05). 33 adverse events occurred with significant differences between two groups (11 in Group A vs 22 in Group B, P < 0.05). The grades of therapeutic maneuvers in Group A was higher than that in Group B (P < 0.05). Conclusion: It was helpful to be evaluated by EUS for HRGIPCL before endoscopic resection.