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Percutaneous endoscopically assisted transenteric full-thickness gastric biopsy: initial experience in humans.
MedLine Citation:
PMID:  21392758     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: GI neuromuscular diseases (GINMD) can cause severe dysmotility and symptoms. Full-thickness biopsy specimens may help diagnose these disorders histologically. OBJECTIVE: To assess a novel percutaneous endoscopically assisted transenteric (PEATE) biopsy method for obtaining full-thickness gastric tissue in patients with suspected GINMD. DESIGN: Prospective proof-of-concept case series. SETTING: Tertiary care gastroenterology unit. PATIENTS: Ten patients (8 women, mean [standard deviation] age 43 [10] years) with gastroparesis-like symptoms (mean [standard deviation] gastroparesis cardinal symptom index 3.28 [1.46] out of 5) and/or clinical findings suggestive of a gastric GINMD. INTERVENTIONS: All patients underwent PEATE biopsy during standard gastroscopy as an outpatient procedure. Tissue was stained for histology and immunohistochemistry of gut wall elements. Interstitial cells of Cajal (ICC) counts were compared with archived normal gastric tissue from control gastrectomies. MAIN OUTCOME MEASUREMENTS: Biopsy success, complications, histopathological findings according to the London Classification of GINMD. RESULTS: Full-thickness antral tissue suitable for analysis was obtained in 9 in 10 patients (90%). PEATE biopsy was well tolerated by all patients without complications. Histology suggested GINMD in 4 of 9 cases (44%), with possible degenerative leiomyopathy in 2, probable inflammatory leiomyopathy in 1, and abnormal ICC networks (>50% reduction in ICC counts) in 1 patient. LIMITATIONS: PEATE biopsy specimen size is smaller than a standard laparoscopic full-thickness biopsy. CONCLUSIONS: PEATE full-thickness gastric biopsy is a simple and safe method of assessing histopathological abnormalities in gastric GINMD without the need for laparoscopy or general anesthesia.
Authors:
Christopher N Andrews; Paul Mintchev; Emil Neshev; Hughie F Fraser; Martin Storr; Oliver F Bathe; Stefan J Urbanski
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-8
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  -     ISSN:  1097-6779     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
Affiliation:
Centre for Digestive Motility (C.N.A., P.M., E.N., H.F.F., M.S.), Division of Gastroenterology, Department of Medicine, Departments of Surgery and Oncology (O.F.B.) and Department of Anatomic Pathology (S.J.U.), University of Calgary, Calgary, Alberta, Canada.
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