Utility and advantage of the unroofing technique for gastrointestinal subepithelial tumors: A multicenter retrospective cohort study.

Autor: Yamamoto M; Department of Gastroenterology Toyonaka Municipal Hospital Osaka Japan., Nishida T; Department of Gastroenterology Toyonaka Municipal Hospital Osaka Japan., Uema R; Department of Gastroenterology and Hepatology Osaka University Graduate School of Medicine Osaka Japan., Kanesaka T; Department of Gastrointestinal Oncology Osaka International Cancer Institute Osaka Japan., Ogawa H; Department of Gastroenterology Nishinomiya Municipal Central Hospital Hyogo Japan., Kitamura S; Department of Gastroenterology Sakai City Medical Center Osaka Japan., Iijima H; Department of Gastroenterology Osaka Police Hospital Osaka Japan., Nagai K; Department of Gastroenterology Suita Municipal Hospital Osaka Japan., Tsutsui S; Departments of Gastroenterology and Hepatology Itami City Hospital Hyogo Japan., Komori M; Department of Gastroenterology Hyogo Prefectural Nishinomiya Hospital Hyogo Japan., Yamamoto K; Department of Gastroenterology Japan Community Healthcare Organization Osaka Hospital Osaka Japan., Tsujii Y; Department of Gastroenterology and Hepatology Osaka University Graduate School of Medicine Osaka Japan., Hayashi Y; Department of Gastroenterology and Hepatology Osaka University Graduate School of Medicine Osaka Japan., Takehara T; Department of Gastroenterology and Hepatology Osaka University Graduate School of Medicine Osaka Japan.
Jazyk: angličtina
Zdroj: DEN open [DEN Open] 2024 Jan 19; Vol. 4 (1), pp. e332. Date of Electronic Publication: 2024 Jan 19 (Print Publication: 2024).
DOI: 10.1002/deo2.332
Abstrakt: Background and Aim: Various techniques for direct biopsy from gastrointestinal subepithelial tumors (SETs) have been reported, although no standard method has been established. A common feature of these techniques is the removal of overlaying mucosa to enable direct biopsies from the SETs. These methods have been synthesized under the collective term "unroofing technique". We conducted a multicenter retrospective study to assess its efficacy and identify potential complications.
Methods: This study was conducted in 10 hospitals and involved all eligible patients who underwent unroofing techniques to obtain biopsies for gastrointestinal SETs between April 2015 and March 2021. The primary endpoint was the diagnostic accuracy of the unroofing technique, and the secondary endpoints were the incidence of adverse events and the factors contributing to the accurate diagnosis.
Results: The study included 61 patients with 61 gastrointestinal SETs. The median tumor size was 20 mm, and the median procedure time was 38 min, with 82% successful tumor exposure. The rate of pathological diagnosis was 72.1%. In 44 patients with a pathological diagnosis, two showed discrepancies with the postresection pathological diagnosis. No factors, including facility experience, organ, tumor size, or tumor exposure, significantly affected the diagnostic accuracy. There was one case of delayed bleeding and two cases of perforation.
Conclusion: The diagnostic yield of the unroofing technique was acceptable. The unroofing technique was beneficial regardless of institutional experience, organ, tumor size, or actual tumor exposure.
Competing Interests: None.
(© 2024 The Authors. DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society.)
Databáze: MEDLINE
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