Retrospective investigation of the diagnostic effectiveness of endoscopic ultrasound in gastrointestinal subepithelial lesions

Gastrointestinal subepithelial lesions are generally asymptomatic and are detected incidentally by endoscopy or other imaging methods. Endosonography provides the possibility of biopsy for diagnosis, as well as contributing to the layer of origin of subepithelial lesions, characterization, evaluation of malignancy potential. In our study, we aimed to retrospectively evaluate the diagnostic efficiency of EUS procedure in gastrointestinal subepithelial lesions as a center where large-volume endoscopic ultrasonography (EUS) is performed. In our study, the data of all patients over the age of 18 who applied to the Fırat University Hospital Endoscopy Unit between November 2013 and October 2020 and underwent EUS for gastrointestinal supepithelial lesion were retrospectively scanned. The data about the patients were obtained from the hospital information system and the patient files kept in the hospital archive. When EUS results were evaluated, 77 (38.3%) of 201 patients were leiomyoma, 63 (31.3%) lipoma, 43 (21.4%) gastrointestinal stromal tumor (GIST), 8 (4%) ectopic pancreas, 7 ( 3.5% were esophageal duplication cysts and 3 (1.5%) were found to be other (mucinous cystic lesion, mucinous cystic adenoma and esophageal ca.). 122 of 201 patients who underwent EUS with the preliminary diagnosis of gastrointestinal subepithelial lesion had biopsy or postoperative pathology results, and the pathology results of 20 (16.4%) patients were reported as insufficient cytology and the diagnosis could not be reached. The diagnosis was reached as a result of pathology in 102 (83.6%) of the patients. When compared with the EUS result, the diagnosis of 90 (88.2%) patients, whose diagnosis was reached as a result of pathology, was compatible with the EUS result, and the results of 12 (11.8%) patients were not compatible with EUS. In conclusion, EUS is a method that has become increasingly popular in recent years in terms of evaluating gastrointestinal submucosal lesions, determining the layer of origin, determining the lesion characteristics and giving an idea about the diagnosis. vi In addition, EUS-guided fine-needle aspiration biopsy (FNAB) can be taken, it is a minimally invasive method and provides strong clues about the diagnosis, thus reducing the number of unnecessary surgeries and helping in early diagnosis. Keywords: Endosonography, gastrointestinal subepithelial lesions, submucosal lesions