为了总结和讨论内镜超声（EUS）在选择上消化道粘膜下肿瘤（SMTs）的内镜治疗中的指导作用。本研究回顾性调查了2019年5月至2021年9月中山大学中医药第二附属医院内镜中心的156名接受EUS指导下内镜切除的SMT患者。随后，分析了病变的大小、病理类型和分布；探讨了肿瘤起源与病变分布和治疗选择的相关性；总结并分析了术前EUS诊断与术后病理诊断的一致性。 纳入的SMT患者的瘤体直径范围为0.3至4厘米，平均直径为0.95厘米；病变主要位于食管、胃底或贲门和胃体。在病理类型方面，食管最常见的肿瘤是肌瘤，贲门和胃体主要位于肌膜固有层和黏膜层的肌瘤和间质瘤，而异位胰腺主要在胃窦中发现。在38位食管SMT患者中，部分病变起源于EUS下的黏膜肌层和次黏膜层主要进行内镜黏膜下剥离术（ESD）和内镜带扎术（EBL）；而病变起源于肌层的患者主要接受黏膜下隧道内镜手术（STER）。在115位EUS下的胃SMT患者中，起源于黏膜肌层和次黏膜层的病变主要进行内镜黏膜下刮出术（ESE），而起源于肌层的病变则主要接受ESE、ESD和内镜全厚度切除术（EFTR）。此外，在EUS下，3位十二指肠SMT患者的病变起源位于黏膜肌层和肌层，分别进行了ESD和ESE。此外，121例患者的EUS诊断与术后病理性质一致，一致率为84.6%。 通过术前EUS明确病变的起源层、大小、生长模式和病理性质可以指导精确选择内镜治疗，从而确保手术结果安全、有效和完全，并减少并发症。 © 2023. BioMed Central Ltd., part of Springer Nature.

To summarize and discuss the guiding role of endoscopic ultrasound (EUS) in selecting endoscopic treatments for submucosal tumors (SMTs) in the upper gastrointestinal tract.A retrospective investigation was conducted on 156 SMT patients who received endoscopic resection guided by EUS in the endoscopy center of the Second Affiliated Hospital of Guangzhou University of Chinese Medicine from May 2019 to September 2021. Next, the size, pathological type, and distribution of lesions were analyzed; the correlation of the tumor origin with distribution of lesions and selection of treatments was explored; and the consistency of preoperative EUS diagnosis and postoperative pathological diagnosis was summarized and analyzed.The tumor diameters of the included SMT patients ranged from 0.3 to 4 cm, with a mean diameter of 0.95 cm; the lesions were mostly located in the esophagus, gastric fundus or fundic cardia and gastric body. As for the pathological types, liomyoma was the most common tumor in the esophagus, liomyoma and mesenchymoma were mainly located in the fundic cardia and gastric body, and heterotopic pancreas was mostly discovered in the gastric sinus. Among 38 esophageal SMT patients, some with lesions originating from muscularis mucosa and submucosa under EUS mainly underwent endoscopic submucosal dissection (ESD) and endoscope band ligation (EBL); while others with lesions originated from muscularis propria mainly received submucosal tunneling endoscopic resection (STER). Of 115 gastric SMT patients under EUS, some with lesion origins from the muscularis mucosa and submucosa mainly underwent endoscopic submucosal excavation (ESE), while others from muscularis propria mainly underwent ESE, ESD, and endoscopic full-thickness resection (EFTR). Besides, 3 duodenal SMT patients with lesion origins from submucosa and muscularis propria under EUS were given ESD and ESE, respectively. Additionally, 121 cases showed a consistency between the EUS diagnosis and the postoperative pathological nature, and the consistency rate was 84.6%.Clarifying the origin layer, size, growth pattern, and pathological nature of the lesion through preoperative EUS can guide the precise selection of endoscopic treatments, thereby ensuring a safe, effective, and complete surgical outcomes and reducing complications.© 2023. BioMed Central Ltd., part of Springer Nature.