Microvasculature of the esophagus and gastroesophageal junction: Lesson learned from submucosal endoscopy

• 作者: Akira Yoshida Bu'Hussain Hayee Esperanza Grace Santi Haruhiro Inoue Haruo Ikeda Hiroki Sato Manabu Onimaru Roberta Maselli Shin-Ei Kudo
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: 微脉管系统 食道的解剖 Submucosal 内视镜检查法 每口头的内视镜的肌切开术 先进成像
• 年，卷（期）: 2016,（19）
• 页码范围: 690-696
• 页数: 0页
• 分类号: R571

摘要

Advanced therapeutic endoscopy,in particular endoscopic mucosal resection,endoscopic submucosal dissection,per-oral endoscopic myotomy,submucosal endoscopic tumor resection opened a new era where direct esophageal visualization is possible.Combining these information with advanced diagnostic endoscopy,the esophagus is organized,from the luminal side to outside,into five layers(epithelium,lamina propria with lamina muscularis mucosa,submucosa,muscle layer,adventitia).A specific vascular system belonging to each layer is thus visible: Mucosa with the intra papillary capillary loop in the epithelium and the sub-epithelial capillary network in the lamina propria and,at the lower esophageal sphincter(LES) level with the palisade vessels; submucosa with the drainage vessels and the spindle veins at LES level; muscle layer with the perforating vessels; periesophageal veins in adventitia.These structures are particularly important to define endoscopic landmark for the gastro-esophageal junction,helpful in performing submucosal therapeutic endoscopy.