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CC BY 4.0 · Endosc Int Open 2024; 12(10): E1183-E1189
DOI: 10.1055/a-2417-0580
Original article

Efficacy of EUS-guided keyhole biopsies in diagnosing subepithelial lesions of the upper gastrointestinal tract

Sen Verhoeve
1   Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, Netherlands (Ringgold ID: RIN6993)
2   Department of Gastroenterology and Hepatology, Maasstad Hospital, Rotterdam, Netherlands (Ringgold ID: RIN7000)
,
Cynthia Verloop 
1   Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, Netherlands (Ringgold ID: RIN6993)
2   Department of Gastroenterology and Hepatology, Maasstad Hospital, Rotterdam, Netherlands (Ringgold ID: RIN7000)
,
Marco Bruno
1   Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, Netherlands (Ringgold ID: RIN6993)
,
Valeska Terpstra
3   Department of Pathology, Medical Centre Haaglanden, Den Haag, Netherlands (Ringgold ID: RIN2901)
,
Lydi Van Driel
1   Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, Netherlands (Ringgold ID: RIN6993)
,
Lars Perk
4   Department of Gastroenterology and Hepatology, Medisch Centrum Haaglanden, Den Haag, Netherlands (Ringgold ID: RIN2901)
,
Lieke Hol
2   Department of Gastroenterology and Hepatology, Maasstad Hospital, Rotterdam, Netherlands (Ringgold ID: RIN7000)
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Abstract

Background and study aims Tissue acquisition is required for diagnosis of subepithelial lesions (SELs). However, obtaining adequate tissue remains challenging. This study investigated an EUS-guided technique using a forceps to create a channel and take multiple biopsies from the center of the lesion, therefore called endoscopic ultrasound-guided keyhole biopsy (EUS-KB).

Patients and methods A retrospective cohort study was conducted in 56 patients with SELs in the upper gastrointestinal tract who were scheduled to undergo EUS-KB. The primary aim was to assess diagnostic yield, defined as the percentage of procedures where EUS-KB resulted in a definitive histopathological diagnosis. Furthermore, factors influencing diagnostic yield were investigated. Additional outcomes included technical success and adverse events.

Results Technical success was achieved in 55 of 60 biopsies (91.7%). EUS-KB provided a diagnosis in 44 of 55 biopsies (80.0%), histology mostly showing gastrointestinal stromal tumor or leiomyoma. The diagnostic yield was not significantly influenced by the size or location of the SEL. Adverse events occurred in one patient (1.7%).

Conclusions EUS-KB is a feasible and safe technique for obtaining a classifying diagnosis for SELs in the upper gastrointestinal tract. It could offer an alternative diagnostic modality, especially in lesions smaller than 20 mm.

Keywords

Endoscopic ultrasonography - Subepithelial lesions - Tissue diagnosis - Quality and logistical aspects - Performance and complications

Supplementary Material



Publikationsverlauf

Eingereicht: 01. Juli 2024

Angenommen nach Revision: 13. September 2024

Artikel online veröffentlicht:
15. Oktober 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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