Endoscopic Biopsy by Mucosal Incision for Upper Gastrointestinal Submucosal Tumors

Histological diagnosis of upper gastrointestinal submucosal tumors (SMT) is a prerequisite for selecting the proper therapeutic approach. EUS-FNA has improved the evaluation of SMT. Endoscopic biopsy by mucosal incision (EBM) is a diagnostic procedure developed by Yokohata et al. The principal aim of this study was to examine the potential of EBM, as an alternative to the more expensive and technically-demanding EUS-FNA, in diagnosing SMT. This retrospective study included a consecutive series of 27 patients (15 males and 12 females, mean age 60.1 years) undergoing EBM and 11 patients (7 males and 4 females, mean age 65.7 years) undergoing EUS-FNA. The tumors had diameters of 15 mm or more, and were suspicious for continuity with the fourth layer as determined by EUS. We compared the diagnostic accuracy and the operating time of EBM with those of EUS-FNA.

Results

The diagnostic accuracies of EBM and EUS-FNA were 85.2% (23/27) and 90.0% (9/10) respectively. The average operating time of EBM and EUS-FNA was 20 min and 41.0 min respectively. During our investigation no major complications were encountered in either group.

Conclusion

EBM matches EUS-FNA in diagnostic accuracy of SMT and is more time and cost-efficient.