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Micro-Biopsy Forceps in the Assessment of Peritoneal Carcinomatosis: A Possible New Indication?
Cecilia Binda,Emanuele Dabizzi,Emanuele Sinagra,Adele Fornelli,Luca Saragoni,Vincenzo Cennamo,Andrea Anderloni,Carlo Fabbri 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.4
Peritoneal carcinomatosis (PC) is defined as a metastatic involvement of the peritoneum by several other primary sites and it ischaracterized by a marked worsening of prognosis, with limited treatment opportunities. Subsequently, PC should be ruled outbefore any invasive treatment is administered. A new through-the-needle micro-biopsy forceps (MF) was recently introduced thatpermits micro-histology cores. In this case series, we evaluated the feasibility of MF in the assessment of PC to complete patientdiagnostic work-ups. Five consecutive patients referred for endoscopic ultrasound staging were sampled using MF. Sampling wasfeasible in all patients with a technical success of 100%. No adverse events were reported in any cases. This technique was feasibleand safe with a technical success rate of 100%. It permitted sampling of peritoneal irregularity, obtained high-quality tissue fragmentsin all cases, and enabled an additional assessment, i.e., immunohistochemical staining.
Germana de Nucci,Maria Chiara Petrone,Nicola Imperatore,Edoardo Forti,Roberto Grassia,Silvia Giovanelli,Laura Ottaviani,Vincenzo Mirante,Giuseppe Sabatino,Carlo Fabbri,Mauro Manno,Paolo Giorgio Arcidi 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.2
Background/Aims: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is the go-to method for obtaining samplesfrom gastrointestinal tract and pancreatic lesions. When the transduodenal approach is utilized, the use of a more flexible needle,such as a nitinol 19-gauge (G) needle, has been recommended. The aim of this study was to evaluate the feasibility and accuracy of19-G flexible aspiration needles in obtaining samples from solid lesions through a transduodenal approach. Methods: This was a retrospective analysis of prospectively collected data from eight Italian endoscopy centers. Consecutive patientswith solid lesions who underwent transduodenal EUS-FNA with a 19-G flexible needle were included. Results: A total of 201 patients were enrolled. According to histology, EUS, radiology and 12 months of follow-up, 151 patientshad malignant lesions and 50 patients had benign lesions. EUS-FNA was feasible in all cases. An adequate histologic sample wasobtained in all except eight cases (96.1%). The sensitivity of EUS-FNA was 92.1% (95% confidence interval [CI], 86.8%–95.7%), andthe specificity was 100% (95% CI, 90.5%–100%). The positive predictive value was 100% (95% CI, 93.4%–100%), and the negativepredictive value was 74% (95% CI, 62.8%–82.7%). The diagnostic accuracy was 93.5% (95% CI, 89.2%–96.5%). Conclusions: The transduodenal approach for obtaining samples from solid lesions using a 19-G flexible needle seems feasible andaccurate.