Résumé
Le développement des techniques de traitement endoscopique des cancers superficiels du tube digestif (mucosectomie endoscopique) impose, avant de mettre en route de tels traitements, d’avoir un bilan loco-régional (pariétal et ganglionnaire) aussi précis que possible. En effet, la mucosectomie endoscopique (ME) ne peut s’appliquer qu’à des tumeurs n’ayant qu’un faible risque de diffusion ganglionnaire; or ce risque est trés lié à l’infiltration locale de la lésion et seules les lésions limitées à la muqueuse voire au premier tiers de la sous-muqueuse (sm1) pourront bénéficier d’un traitement endoscopique.
La question posée est de savoir si l’échoendoscopie (EE) peut visualiser une infiltration de la sous-muqueuse (c’est-à-dire le franchissement de lamuscularis mucosae) de maniére fiable. Par ailleurs, la place de l’EE est à moduler en fonction de l’organe en cause (œsophage, estomac, côlon et rectum).
Summary
The development of the techniques of endoscopic treatment of superficial cancers of the digestive tract (endoscopic mucosectomy) requires before starting a loco-regional assessment (parietal and lymph nodes) as precise as possible. Indeed, the endoscopie mucosectomy (ME) can apply only to tumours with a low risk of lymph node invasion, but this risk is quite related to the local infiltration of the lesion and only the lesions limited to the mucous membrane or to the first third of the submucosa (sml) will be treated by EMR. The question is to know whether echoendoscopy (EUS) can visualize an infiltration of the submucosa (i.e. crossing the muscularis mucosae) in a reliable way. In addition, the place of EE is to be modulated according to the organ concerned (oesophagus, stomach, colon and rectum).
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Giovannini, M., Pesenti, C., Guillin, A. et al. L’échoendoscopie par mini-sonde de haute fréquence est-elle nécessaire avant une mucosectomie endoscopique?. Acta Endosc 35, 87–92 (2005). https://doi.org/10.1007/BF03002653
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DOI: https://doi.org/10.1007/BF03002653