Endoscopic Biopsy by Mucosal Incision for Upper Gastrointestinal Submucosal Tumors

Okuzono, Toru; Mishima, Toshiyuki; Badran, Adel; Mizuno, Hiroyuki; Miyashita, Yusuke; Hamamoto, Hidetaka; Sato, Shun; Miyake, Naoto; Nakahori, Masato; Chonan, Akimichi

doi:10.1016/j.vjgien.2013.08.002

Cited by 4 publications

(12 citation statements)

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“…The diagnostic sensitivity of deep biopsy of subepithelial tumors was 87.5% (28 of 32), similar to other studies, such as a study by Okuzono et al, with diagnostic sensitivity of 85% (23 of 27). Hünerbein et al performed locoregional TN staging in 173 patients with esophageal‐gastric cancer and concluded that the results were similar with a 12.5‐MHz miniprobe and 7.5‐MHz linear endoscopic sonography.…”

Section: Discussionsupporting

confidence: 88%

Miniprobe Endoscopic Sonography for Gastrointestinal Tract Assessment: A Case Series of 1451 Procedures

Lorenzo

Belando²,

Mengual³

2017

J of Ultrasound Medicine

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Ram on Abad Belando, MBBS, Elena S anchez-Vizca ıno Mengual, MScConventional endoscopic sonography has allowed precise diagnostics without disturbances, and miniprobes can be easily introduced through the biopsy channel of the endoscope. Miniprobe endoscopic sonography has many benefits compared with conventional endoscopic sonography. Although there are well-known indications for miniprobe endoscopic sonography in endoscopic digestive tract assessment, there is still a need for this method to be widely spread among physicians and commonly used by most endoscopists. The aim of this series was to describe a multicenter retrospective experience with 1451 procedures using miniprobes, presenting examples and the applicability and usefulness of this technology in the daily activities of an endoscopy department.

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Section: Discussionsupporting

confidence: 88%

Miniprobe Endoscopic Sonography for Gastrointestinal Tract Assessment: A Case Series of 1451 Procedures

Lorenzo

Belando²,

Mengual³

2017

J of Ultrasound Medicine

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“…Consequently, less time is required, a pathologist in the room is not required, it can be done using conventional materials and might be cost-effective, according to a recent study[ 15 ] [ Table 3 ].…”

Section: Discussionmentioning

confidence: 99%

Canalization technique to obtain deep tissue biopsy of gastrointestinal subepithelial tumors as an alternative to conventional known techniques

Abad-Belando¹,

Varas-Lorenzo²,

Pons-Vilardell

et al. 2018

Endosc Ultrasound

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Background and Objectives:The most accurate technology to detect and diagnose subepithelial tumors (SETs) is the endoscopic ultrasonography (EUS) combined with puncture techniques, such as the endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) or the endoscopic ultrasonography-guided fine-needle biopsy. Going further in the improvement of the results of tumor samples obtained endoscopically to diagnose the SETs, the canalization technique guided by miniprobes (MPs) to obtain biopsies of SET could be an alternative to EUS-FNA. The objective of this study is to analyze the results of samples obtained by this procedure.Materials and Methods:A multicenter, retrospective study of a review of a database of 32 consecutive patients with a SET in the digestive tract, from 2000 to 2015 was conducted. All patients underwent EUS-performed by MP, to define the size, internal echostructure, and layer of origin of tumor. Once the echostructure was defined, it proceeded to the canalization technique to arrive to the tumor tissue.Results:The average diameter of SETs in this series (32 patients) was about 21.6±11 mm (range: 5–41 mm). The diagnostic accuracy was 28/32, 87.50% (Confidence interval 95%: 76.04%–98.99%), and there were no major complications. All procedures were performed on outpatients, none of which required additional hospitalization. The 50% of patients were operated or endoscopically resected and in all cases, the previous pathological diagnosis was confirmed.Conclusions:This is a feasible, safe, and effective procedure that allows to access to inside of SET to obtain deep biopsies. Tumor samples obtained by deep biopsy, with prior performing of the canalization technique guided by MP, were sufficient for histopathological and immunohistochemical diagnosis and similar to those obtained with other known methods (FNA Trucut, ProCore®, etc.). However, more prospective comparative studies with a larger number of patients and different specialists carrying out the procedure to reach a higher statistical significance are necessary.

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“…However, the accuracy of EUS-based approaches falls as lesions diminish in size, with accuracy falling to as low as 50% in lesions smaller than 20 mm [7]. This variability in accuracy, along with other drawbacks, such as the cost of EUS-FNA, the average time it entails, and the required level of expertise required from an advanced endoscopist, has left the window open for improvements and alternative tissue sampling modalities [8].…”

Section: Introductionmentioning

confidence: 99%

“…As the evolution of diagnostic methods for upper GI SETs continues, alternatives such as mucosal incision assisted biopsy (MIAB) have been developed, with a reported diagnostic yield of 89% [8]. This technique was developed by Yokohata et al in 2007.…”

Section: Introductionmentioning

confidence: 99%

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Clinical efficacy and safety of mucosal incision-assisted biopsy for the diagnosis of upper gastrointestinal subepithelial tumors: A systematic review and meta-analysis

Dhaliwal

Kolli

Dhindsa

et al. 2020

aog

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Background Endoscopic ultrasound-guided fine-needle aspiration and biopsy (EUS-FNA/FNB) has been traditionally used for making a tissue diagnosis. Several newer techniques are emerging as a viable alternative to EUS-FNA/FNB, including mucosal incision-assisted biopsy (MIAB), with a view to increasing the diagnostic yield for upper gastrointestinal (GI) subepithelial tumors (SETs). We conducted a systematic review and meta-analysis to describe the overall diagnostic yield of MIAB for upper GI SETs.Methods Multiple electronic databases (MEDLINE, EMBASE and Google Scholar) and conference abstracts were comprehensively searched. The primary outcome of our meta-analysis was the overall diagnostic yield of the MIAB. The secondary outcome was to study complications in terms of perforation and clinically significant bleeding. The meta-analysis was performed using a DerSimonian and Laird random-effect model. ResultsSeven studies were included in the final meta-analysis, reporting a total of 159 patients (male 86, female 73) with a mean age of 58 years. The overall pooled diagnostic yield of MIAB was 89% (95% confidence interval [CI] 82.65-93.51, I 2 =0.00). Histologically, GI stromal tumor was the reported diagnosis in 38.62% (95%CI 22.29-56.24, I 2 =77.51%) of tumors, followed by leiomyoma 25% (95%CI 18.02-32.62, I 2 =4.42%). The overall rate of clinically significant bleeding following the procedure was 5.03% (95%CI 0.36-12.86, I 2 =57.43%) and no perforations were reported.Conclusions MIAB is a safe and effective technique for the diagnosis of upper GI SETs and can be considered as a viable alternative to EUS-FNA/FNB. MIAB can be performed during routine endoscopy and no advanced equipment is required.

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Endoscopic Biopsy by Mucosal Incision for Upper Gastrointestinal Submucosal Tumors

Cited by 4 publications

References 3 publications

Miniprobe Endoscopic Sonography for Gastrointestinal Tract Assessment: A Case Series of 1451 Procedures

Miniprobe Endoscopic Sonography for Gastrointestinal Tract Assessment: A Case Series of 1451 Procedures

Canalization technique to obtain deep tissue biopsy of gastrointestinal subepithelial tumors as an alternative to conventional known techniques

Clinical efficacy and safety of mucosal incision-assisted biopsy for the diagnosis of upper gastrointestinal subepithelial tumors: A systematic review and meta-analysis

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