Simplified Submucosal Tunneling Biopsy Using Clip-With-Line Traction and Closure for Gastric Subepithelial Lesion.

Hideki Kobara,Tsutomu Masaki,Naoya Tada,Shintaro Fujihara,Noriko Nishiyama,Nobuya Kobayashi

doi:10.3390/diagnostics10090690

Abstract

Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) has emerged as a standard and convenient method for the sampling of subepithelial lesions (SELs). Immunohistological analysis is required to definitively distinguish mesenchymal tumors; however, EUS-FNA provides insufficient material to achieve this, especially for small SELs < 2 cm. We therefore previously reported a novel submucosal tunneling biopsy (STB) technique that utilizes endoscopic submucosal dissection (ESD) for sampling SELs. However, unresolved advanced technical issues have hindered its widespread application. Currently, a counter-traction technique is used to facilitate ESD. We here describe a technically simplified STB technique using clip-with-line traction for gastric SELs.

Highlights

Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) has emerged as a Astbasntdraacrtd: Eannddosccoopnicveunliternastoumndeth(EoUd S)-fgoruidtehde finseamnpeelidnlge asopf irastuiobnep(iFthNeAlia)lhalseseimonesrge(dSEaLssa). sItmanmduanrdohanisdtocloongviceanliaenntamlyesitshoisdrfeoqrutihreedsatmo dpleifningiotifvseulbyedpiistthinelgiaulislehsimonesse(SnEchLys)m
Our strategy proposes that EUS-FNA must be the first option for the sampling of SELs, followed by this method as the second alternative for unsuccessful FNA cases
This simplified STB (Supplementary Video S1) technique may be an acceptable means of sampling SELs

Summary

Introduction

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Results

Conclusion