Tissue diagnosis of GI subepithelial tumor only through Trucut biopsy under a forward-viewing endoscope: applicability as newer diagnostic modality
- Authors
- Ko, Weon Jin; Song, Ga Won; Hahm, Ki Baik; Hong, Sung Pyo; Cho, Joo Young; Cho, Jun-Hyung; Jin, So Young
- Issue Date
- Nov-2016
- Publisher
- Springer Verlag
- Keywords
- Trucut biopsy; Subepithelial tumor; Forward-viewing endoscope
- Citation
- Surgical Endoscopy, v.30, no.11, pp 5009 - 5014
- Pages
- 6
- Journal Title
- Surgical Endoscopy
- Volume
- 30
- Number
- 11
- Start Page
- 5009
- End Page
- 5014
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/8640
- DOI
- 10.1007/s00464-016-4846-5
- ISSN
- 0930-2794
1432-2218
- Abstract
- Trucut biopsy (TCB) has been proposed to overcome the limitations of endoscopic ultrasonography (EUS)-guided fine-needle aspiration for the pathologic diagnosis of upper gastrointestinal (GI) subepithelial tumor (SET); however, it can be difficult to perform because the Trucut biopsy needle is very stiff. Although technical failures have been reported with the use of TCB, recently the forward-viewing echoendoscope showed a high diagnostic accuracy. We hypothesized that TCB under a conventional forward-viewing endoscope can be applied with higher yield of tissue diagnosis. To evaluate the feasibility of TCB under a forward-looking endoscopy without cumbersome EUS guidance, we introduced a 19-gauge TCB needle into the working channel of a conventional upper endoscope in 27 patients with GI SET to make tissue diagnosis. Prospectively collected data were analyzed, including technical success rate, pathologic result, and adverse events. Twenty-seven patients with GI SET (18 esophageal tumors and nine gastric tumors) underwent TCB under a forward-looking endoscope. All procedures were performed safely without any TCB-related complications. Subsequently, histopathology examination revealed gastrointestinal stromal tumors (GISTs) in three cases and leiomyomas in 21 cases. Histologic assessment was completed in 24 out of 27 patients (88.9 %) because tissue obtained from three patients, whose tumors were located in the stomach, was not sufficient for the pathologic diagnosis. TCB using a conventional forward-viewing endoscope without EUS guidance provided an excellent pathologic diagnosis of upper GI SET.
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