Forward‐viewing endoscopic ultrasound‐guided fine‐needle biopsy using the clip‐with‐thread method for small gastric subepithelial lesions

Minoda, Yosuke; Fujimori, Nao; Ihara, Eikichi

doi:10.1111/den.13476

Cited by 2 publications

(1 citation statement)

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“…Endoscopic ultrasound-guided ne-needle aspiration (EUS-FNA) was introduced in the early 1990s [1,2] and has been widely used as a standard technique to obtain pathological specimens from lesions around the upper gastrointestinal tract (GI), such as pancreatic tumors [3][4][5][6], upper abdominal lymph nodes [7,8], mediastinal masses [9,10], or upper gastrointestinal submucosal tumors [11][12][13][14]. However, the feasibility and safety of EUS-FNA for lower abdominal lesions have not been well studied, although EUS-FNA for pelvic lesions via the lower GI approach was reported in several studies, including one systematic review and meta-analysis [15][16][17], in which target lesions were limited around the rectal or perirectal area.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic ultrasound-guided fine-needle aspiration of pelvic lesions via the upper and lower gastrointestinal tract approaches

Mita

Iwashita

Senju

et al. 2020

Preprint

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Background Combining upper and lower gastrointestinal tract (GI) approaches allows expansion of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) indications for pelvic lesions. The upper GI approach has been used for pelvic lesions around the level of the aortoiliac bifurcation in our institution. The aim of this study is to evaluate the feasibility and safety of EUS-FNA for pelvic lesions via the upper and lower GI approaches. Methods All consecutive patients who underwent EUS-FNA for the pelvic lesion between January 2008 and December 2018 were retrospectively analyzed. Pelvic lesions were defined as lesions located around and below the aortoiliac bifurcation level. The primary outcome was technical success rate, and the secondary outcomes were the diagnostic capability of EUS-FNA for malignancy and the safety. Results EUS-FNA for pelvic lesions was performed in 49 patients—upper and lower GI approaches were used in 28 and 21 patients, respectively. The technical success rates were 91.8% (45/49) in all patients—89.3% (25/28) and 95.2% (20/21) with the upper and lower GI approaches, respectively. Among patients who achieved technical success, the diagnostic accuracy for malignancy was 97.8% (44/45) in all patients—100% (25/25) and 95.0% (19/20) with the upper and lower GI approaches, respectively. One (2.0%) patient developed an adverse event of sigmoid colon perforation. Conclusions EUS-FNA for pelvic lesions via the upper and lower GI approaches was a safe, feasible, and effective method, although careful endoscopic manipulation is reuqired to avoid perforation, especially with the lower GI approach. Further large-scale, well-designed studies are needed to validate our findings.

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