Clinical Endoscopy

Original Article

Performance and Clinical Role of Endoscopic Ultrasound Fine Needle Aspiration for Diagnosing Gastrointestinal Intramural Lesions: Hea Jung Sung, Yu Kyung Cho, Eun Young Park, Sung Jin Moon, Chul Hyun Lim, Jin Su Kim, Jae Myung Park, In Seok Lee, Sang Woo Kim, Myung-Gyu Choi, Kyu Yong Choi; Clin Endosc 2013;46(6):627-632. Published online November 19, 2013; DOI: https://doi.org/10.5946/ce.2013.46.6.627

Background/Aims

We evaluated the performance, clinical role, and diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in gastrointestinal intramural lesions.

Methods

Procedural and pathologic data were reviewed from consecutive patients undergoing EUS-FNA for intramural lesions. Final diagnoses were determined by surgical histopathologic conformation and the diagnosis of malignancy, including clinical follow-up with repeat imaging.

Results

Forty-six patients (mean age, 47 years; 24 males) underwent EUS-FNA. Lesions were located in the stomach (n=31), esophagus (n=5), and duodenum (n=10). The median lesion size was 2 cm (range, 1 to 20.6). Final diagnoses were obtained in 22 patients (48%). EUS-FNA was diagnostic in 40 patients (87%). The diagnostic accuracy of cytology for differentiating between benign and malignant lesions was 82%; diagnostic error occurred in three patients (6%). The cytologic results influenced clinical judgment in 78% cases. The primary reasons for negative or no clinical impact were false-negative results, misdirected patient management, and inconclusive cytology.

Conclusions

EUS-FNA exhibited an 87% diagnostic yield for gastrointestinal intramural lesions; the accuracy of cytology for differentiating malignancy was 82%. The limitations of EUS-FNA were primarily because of nondiagnostic sampling (9%) and probable diagnostic error (6%); these factors may influence the clinical role of EUS-FNA.

Citations

Citations to this article as recorded by

Feasibility and clinical value of linear endoscopic ultrasonography imaging in the lower gastrointestinal subepithelial lesions
Li Tao, Yajun Chen, Qianqian Fang, Fan Xu, Qianwei Yu, Lijiu Zhang, Xiangpeng Hu
Scientific Reports.2024;[Epub] CrossRef
Endoscopic ultrasound‐guided fine needle aspiration cytology diagnosis of upper gastrointestinal tract mesenchymal tumors: Impact of rapid onsite evaluation and correlation with histopathologic follow‐up
Syed M. Gilani, Thiruvengadam Muniraj, Harry R. Aslanian, Guoping Cai
Diagnostic Cytopathology.2021; 49(2): 203. CrossRef
Diagnosis of Gastric Subepithelial Tumor: Focusing on Endoscopic Ultrasonography
Eun Young Kim
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2015; 15(1): 9. CrossRef
Endoscopic Ultrasound-Guided Fine Needle Biopsy without Rapid On-Site Cytologic Examination: A Time to Change the Paradigm?
Yeon Suk Kim
Clinical Endoscopy.2014; 47(3): 207. CrossRef

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4 Crossref

Review

Evidence-Based Recommendations on Colorectal Stenting: A Report from the Stent Study Group of the Korean Society of Gastrointestinal Endoscopy: Kwang Jae Lee, Sang Woo Kim, Tae Il Kim, Jong-Hoon Lee, Bo-In Lee, Bora Keum, Dae Young Cheung, Chang Heon Yang, The Stent Study Group of the Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2013;46(4):355-367. Published online July 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.4.355

Abstract PDF PubReader ePub

Recently, placement of self-expandable metallic stents has been used for the treatment of colorectal obstruction. As domestic awareness of colorectal cancer has increased, the number of colorectal stenting procedures performed has also increased. We aimed to provide evidence-based recommendations for colorectal stenting to aid gastroenterologists in making informed decisions regarding the management of patients who present with colorectal obstruction. The working group consisted of eight gastroenterologists who actively practice and conduct research in the field of colorectal stenting and are the members of the Stent Study Group of the Korean Society of Gastrointestinal Endoscopy. A literature search was conducted using the PubMed, Embase, KoreaMed, and the Cochrane Library databases to identify relevant articles published between January 2001 and June 2012. Based on the modified Delphi process, 10 recommendation statements regarding indications, usefulness, methodology and complications of colorectal stenting, and alternative treatments for malignant colorectal obstruction were determined. The contents will be widely distributed, and periodically revised to reflect the latest knowledge. These evidence-based recommendations for colorectal stenting will provide gastroenterologists and patients with appropriate and balanced information, and will improve the quality of care.

Citations

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Mohammad Arafat, Paris Fouladian, Anton Blencowe, Hugo Albrecht, Yunmei Song, Sanjay Garg
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Bejo Utomo, Carmen Alvarez, Ricardo F. Baldonedo
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Takaya Shimura, Takashi Joh
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Colonic perforation either during or after stent insertion as a bridge to surgery for malignant colorectal obstruction increases the risk of peritoneal seeding
Su Jin Kim, Hyung Wook Kim, Su Bum Park, Dae Hwan Kang, Cheol Woong Choi, Byeong Jun Song, Joung Boom Hong, Dong Jun Kim, Byung Soo Park, Gyung Mo Son
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Tian-Zhi Lim, Dedrick Chan, Ker-Kan Tan
International Journal of Colorectal Disease.2014; 29(10): 1267. CrossRef
Endoscopic stenting for recurrence-related colorectal anastomotic site obstruction: Preliminary experience
Jung Ho Kim
World Journal of Gastroenterology.2014; 20(38): 13936. CrossRef

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Original Article

Performance and Cost of Disposable Biopsy Forceps in Upper Gastrointestinal Endoscopy: Comparison with Reusable Biopsy Forceps: Chul-Hyun Lim, Myung-Gyu Choi, Won Chul Kim, Jin Soo Kim, Yu Kyung Cho, Jae Myung Park, In Seok Lee, Sang Woo Kim, Kyu Yong Choi, In-Sik Chung; Clin Endosc 2012;45(1):62-66. Published online March 31, 2012; DOI: https://doi.org/10.5946/ce.2012.45.1.62

Abstract PDF PubReader ePub

Background/Aims

It is believed that disposable biopsy forceps are more costly than reusable biopsy forceps. In this study, we evaluated performance and cost of disposable forceps versus reusable forceps in esophagogastroduodenoscopic biopsy.

Methods

Between October 2009 and July 2010, we enrolled 200 patients undergoing esophagogastroduodenoscopic biopsy at Seoul St. Mary's Hospital. Biopsies were performed with 100 disposable or 5 reusable forceps by random assignment. Seventy-five additional patients were studied to estimate durability of reusable forceps. The assisting nurses estimated the performance of the forceps. The evaluation of costs included purchase prices and reprocessing costs. The adequacy of the sample was estimated according to the diameter of the obtained tissue.

Results

Performance of disposable forceps was estimated as excellent in 97.0%, good in 2.0% and adequate in 1.0%. Reusable forceps were estimated as excellent in 36.0%, good in 36.0%, adequate in 25.1% and inadequate in 2.9%. The performance of reusable forceps declined with the number of uses. The reprocessing cost of reusable forceps for one biopsy session was calculated as ₩8,021. The adequacy of the sample was excellent for both forceps.

Conclusions

Disposable forceps showed excellent performance. Considering the reprocessing costs of reusable forceps, usage of disposable forceps with a low price should be considered.

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Zaheer Nabi, Raymond S. Y. Tang, Sridhar Sundaram, Sundeep Lakhtakia, D. Nageshwar Reddy
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Jonathan Lans, Ritsaart F. Westenberg, Svenna H.W.L. Verhiel, Rohit Garg, Jesse B. Jupiter, Neal C. Chen
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Multidisciplinary and Multisociety Practice Guideline on Reprocessing Flexible Gastrointestinal Endoscopes and Endoscopic Accessories
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Korean Society of Gastrointestinal Endoscopy Guidelines for Endoscope Reprocessing
Byoung Kwan Son, Byung-Wook Kim, Won Hee Kim, Dae-Sung Myung, Young-Seok Cho, Byung Ik Jang
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Byung-Wook Kim, Byoung Kwan Son, Won Hee Kim, Dae-Sung Myung, Young-Seok Cho, Byung Ik Jang
The Korean Journal of Medicine.2017; 92(3): 239. CrossRef
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