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T L Tio

Publications and source records attributed to T L Tio.

59 records · Page 4Linked to original sources
PubMedDate not supplied

Endosonography in the clinical staging of esophagogastric carcinoma.

Endosonography (ES) was preoperatively performed in 113 patients with esophageal carcinoma (group 1) and in 84 patients with gastric carcinoma (group 2). Results of imaging and histology of resected specimens were correlated according to the new (1987) TNM classification. ES was accurate in assessing the depth of tumor infiltration. Overall accuracy of ES for group 1 was 89% and for group 2 83%. Early carcinomas could be distinguished from advanced cancers. ES was accurate in diagnosing lymph node metastases (sensitivity group 1 95% and group 2 87%) but less accurate in defining inflammatory changes of lymph nodes (specificity group 1 50% and group 2 48%). The incidence of lymph node metastases increased with progression of the depth of tumor infiltration. ES is not accurate for staging distant metastasis due to the limited penetration depth of ultrasound. Thus, additional transcutaneous ultrasound or computed tomography is necessary. Routine ES-guided cytology of lymph nodes may further enhance the diagnostic accuracy of ES.

Adolescent↗
PubMedDate not supplied

Endosonography of peri-anal and peri-colorectal fistula and/or abscess in Crohn's disease.

Transcolorectal endosonography (ES) was performed in 36 patients with Crohn's disease suspected clinically to have a fistula or abscess. A hypoechoic or anechoic duct-like lesion immediately adjacent to the anorectal lumen compatible with a fistula was found in 32 patients. A communication between the fistulous tract and adjacent structures such as the skin, anal canal, or vagina was detected in all 32 patients. An anechoic cavity adjacent to or communicating with the fistula was visualized in 29 of the 36 patients. A fistula was visualized in the remaining seven patients with no evidence of an abscess. This anechoic cavity compatible with an abscess was surgically confirmed in 14 of 17 patients. We judged the extent and configuration of the abnormalities to be more clearly visualized by ES when results were compared with fistulography in five patients. There were no ES complications, and we conclude that ES is the preferred diagnostic procedure in patients with peri-rectal pathology because of the low risk of bacterial dissemination and low incidence of patient discomfort. Utilizing ES after non-surgical treatment was successful in 19 patients for documentation of the response to therapy.

Abscess↗
PubMedDate not supplied

Endoscopic ultrasonography for the evaluation of smooth muscle tumors in the upper gastrointestinal tract: an experience with 42 cases.

Before surgery, 12 patients with suspected leiomyoma and 12 patients with suspected leiomyosarcoma were studied by endoscopic ultrasonography (EUS), computed tomography (CT), endoscopy, and barium swallow. The results were correlated with surgery and histology. Ten leiomyomas, one benign gastric ulcer, one carcinoid metastasis, eight leiomyosarcomas, two leiomyoblastomas, one mucus secreting adenocarcinoma, and one bronchial carcinoma were diagnosed. Eighteen additional patients suspected to have benign submucosal lesions by endoscopy and barium meal were treated non-surgically, and studied by EUS and CT. EUS was superior to other imaging techniques in the detection, staging, and follow-up of submucosal smooth muscle tumors because of clear imaging of the intramural abnormality and adjacent lymph nodes.

Barium Sulfate↗
PubMedDate not supplied

Video-endoscopic ultrasonography in staging gastric carcinoma.

BACKGROUND/AIMS: Clinical staging of gastric carcinoma is important in designing the strategy of treatment. Early gastric carcinomas can be treated by minimally invasive therapy, whereas advanced gastric carcinomas should be treated by surgery with or without combined chemotherapy. This study was undertaken to evaluate the accuracy and limitations of video type endoscopic ultrasound in preoperative staging of gastric cancer and assessing lymph node metastasis. METHODOLOGY: Seventy-four patients with gastric carcinoma were preoperatively staged using video-endoscopic ultrasonography, performed by the same gastroenterologist. RESULTS: Sixty-three out of the 74 (85%) patients were correctly staged by endoscopic ultrasonography. The diagnostic accuracy rate was 100% for T1, 74% for T2, 87% for T3, and 86% for T4. Overstaging occurred in 11% due to peritumoral inflammation. Understaging occurred in 4% due to microinvasion of carcinomatous tissue or deeper organ invasion. The diagnosis of lymph node metastasis was confirmed in 72% of cases. Sensitivity and specificity was 74% and 86%, respectively. CONCLUSIONS: Endoscopic ultrasonography has a high accuracy rate in staging gastric carcinoma but still has its limitations in evaluating regional lymph node metastasis, despite using a new generation video-endoscopic ultrasonography.

Adenocarcinoma↗