Endoscopic ultrasonography (EUS) is a technique that combines endoscopy and ultrasound. Currently the main application of EUS in the upper gastrointestinal system is for assessment of benign and malignant lesions. In Scotland the incidence of oesophageal cancer is approximately 14 per 100,000. Where overall five year survival remains low (5-10%) and two-thirds of patients have irresectable disease at diagnosis. Caveats of the technique include limited ability to assess lesions when the scope cannot be negotiated through malignant strictures, the relative inaccuracy of EUS to assess tumours post-radio or chemotherapy or recurrence following an operation and the inability to detect the number of nodes observed when the tumour is excised and studied histologically. Furthermore EUS is operator dependent and although can provide adequate information regarding depth of tumour invasion, length of lesions can be wrongly estimated over 20%.
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