Efficacy and safety of cold forceps biopsy for diminutive pharyngeal neoplasms: Single‐center, prospective pilot study
| Autor: | Kazuhiro Matsueda, Naoyuki Nishimura, Junya Itakura, Akira Doi, Daichi Hira, Rio Takezawa, Tomoki Sumiya, Masahiko Sue, Masayuki Ueno, Yuichi Shimodate, Hirokazu Mouri, Hiroshi Takayama, Sho Ishikawa, Motowo Mizuno, Tomohiko Sunami, Hiroshi Yamamoto |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Biopsy Pilot Projects Single Center Lesion 03 medical and health sciences 0302 clinical medicine Humans Medicine Radiology Nuclear Medicine and imaging Prospective Studies medicine.diagnostic_test business.industry Incidence (epidemiology) Gastroenterology Pharyngeal Neoplasms Surgical Instruments medicine.disease Surgery Endoscopy Pharyngeal Neoplasm Dysplasia 030220 oncology & carcinogenesis Pharynx neoplasm 030211 gastroenterology & hepatology Neoplasm Recurrence Local medicine.symptom business |
| Zdroj: | Digestive Endoscopy. 33:761-769 |
| ISSN: | 1443-1661 0915-5635 |
| DOI: | 10.1111/den.13838 |
| Popis: | Background Management of diminutive pharyngeal neoplasms is controversial. Thus, we conducted a single-center, prospective pilot study to investigate the efficacy and safety of endoscopic excision with cold forceps biopsy (CFB) of these lesions. Patients and methods Thirty-nine lesions endoscopically diagnosed with narrow-band imaging as pharyngeal neoplasms of 3 mm or smaller were excised with CFB using jumbo biopsy forceps (cap diameter 2.8 mm, jaw volume 12.4 mm3 ). The primary outcome was endoscopically determined local remnant/recurrence rate 3 months after CFB. The secondary outcomes were histopathologically determined local remnant/recurrence rate; risk factors associated with the endoscopic remnant/recurrence; and incidence of intraoperative or delayed bleeding and other adverse events. Results Histological diagnosis of the 39 CFB-excised lesions were: 11 high-grade dysplasia (28.2%), 22 low-grade dysplasia (56.4%), two basal cell hyperplasia (5.1%) and four atypical squamous epithelium (10.3%).Twenty-seven patients (30 lesions) underwent follow-up endoscopy 3 months after CFB; the endoscopic and pathological local remnant/recurrence rate was 20% (6/30; 95% confidence interval (CI), 7.7-36.6%) and 16.7% (5/30; 95% CI, 5.6-34.7%), respectively. Location of the lesion in the hypopharynx was a significant risk factor associated with the endoscopic local remnant/recurrence (P = 0.049). No significant adverse events occurred. Conclusions Cold forceps biopsy with jumbo biopsy forceps appears to be a safe and effective technique for excising diminutive pharyngeal neoplasms. Although small, the excised lesions may have a remarkably high frequency of high-grade dysplasia. (Clinical trial registration number: UMIN000037980). |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text