How Good Is Single-Incision Needle-Knife Biopsy in Diagnosing Gastrointestinal Subepithelial Tumors?

How Good Is Single-Incision Needle-Knife Biopsy in Diagnosing Gastrointestinal Subepithelial Tumors?

Vanessa M. Shami, MD, FASGE, reviewing Naga YSE, et al. Gastrointest Endosc 2022 Nov 29.

Tissue sampling of subepithelial lesions (SELs) is needed to determine the diagnosis, malignant potential, and management of these lesions. Endoscopic ultrasound-guided fine needle aspiration and/or biopsy (EUS-FNA and/or FNB) is the most common procedure for tissue acquisition. Bite-on-bite and single-incision with needle-knife (SINK) biopsies have emerged as alternative diagnostic approaches for tissue acquisition, eliminating the need for EUS. This systematic review and meta-analysis evaluated the technical and diagnostic success (primary outcomes) as well as the adverse events (secondary outcomes) of SINK biopsy. 

The authors of this study searched numerous databases and performed a meta-analysis of 7 studies with a total of 219 SINK biopsy procedures. The technical success rate of SINK was 98.1% (95% confidence interval [CI], 94.9%-99.3%; P=.000; I2=0.0%), and the diagnostic success rate was 87.9% (95% CI, 82.6%-91.7%; P=.000; I2=0.0%). Immunohistochemical staining was successfully performed in 88.3% of patients (95% CI, 78.7%-93.9%; P=.000; I2=3.5%). Adverse events occurred in 7.5% of patients (95% CI, 4.3%-12.7%; P=.00; I2=7.2%), with bleeding being the most common (9 cases of bleeding, 1 case of abdominal pain).

Vanessa M. Shami, MD, FASGE

COMMENT

SINK biopsy appears to have high technical and diagnostic success rates in patients with SELs and may be a feasible alternative to EUS-FNA/FNB. However, the adverse event rate is higher than expected for EUS-FNA/FNB. Therefore, randomized controlled trials are needed to compare the success and adverse events of these two techniques.

 

 

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

CITATION(S)

Naga YSE, Dhindsa BS, Deliwala S, et al. Single incision needle knife biopsy for the diagnosis of gastrointestinal subepithelial tumors: a systematic review and meta-analysis. Gastrointest Endosc 2022 Nov 29. (Epub ahead of print) (https://doi.org/10.1016/j.gie.2022.11.021)

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