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Value of macrobiopsies and transanal endoscopic microsurgery in the histological work-up of rectal neoplasms: A retrospective study
AIM: To evaluate a step up approach: Taking macrobiopsies and performing excision biopsies in patients with suspected rectal cancer in which biopsies taken though the flexible endoscope showed benign histology. METHODS: Patients with a rectal neoplasm who underwent flexible endoscopy and biopsies we...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5472555/ https://www.ncbi.nlm.nih.gov/pubmed/28656075 http://dx.doi.org/10.4251/wjgo.v9.i6.251 |
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author | Bökkerink, Guus M J van der Wilt, Gert-Jan de Jong, Dirk van Krieken, Han H J M Bleichrodt, Robert P de Wilt, Johannes H W Bremers, Andreas J A |
author_facet | Bökkerink, Guus M J van der Wilt, Gert-Jan de Jong, Dirk van Krieken, Han H J M Bleichrodt, Robert P de Wilt, Johannes H W Bremers, Andreas J A |
author_sort | Bökkerink, Guus M J |
collection | PubMed |
description | AIM: To evaluate a step up approach: Taking macrobiopsies and performing excision biopsies in patients with suspected rectal cancer in which biopsies taken though the flexible endoscope showed benign histology. METHODS: Patients with a rectal neoplasm who underwent flexible endoscopy and biopsies were included. In case of benign biopsies rigid rectoscopy and macrobiopsies were employed. If this failed to prove malignancy, transanal endoscopic microsurgery (TEM) was used in a final effort to establish a certain preoperative diagnosis. The preoperative results were compared with the findings after surgical excision and follow up to calculate the reliability of this algorithm. RESULTS: One hundred and thirty-two patients were included. One hundred and ten patients with a carcinoma and 22 with an adenoma. Seventy-five of 110 carcinomas were proven malignant after flexible endoscopy. With the addition of rigid endoscopy and taking of macrobiopsies, this number increased to 89. Performing TEM excision biopsies further enlarged the number of proven malignancies to 100. CONCLUSION: The step-up approach includes taking macrobiopsies through the rigid rectoscope and performing excision biopsies using transanal endoscopic microsurgery in addition to flexible endoscopy. This approach, reduced the number of missed preoperative malignant diagnoses from 32% to 9%. |
format | Online Article Text |
id | pubmed-5472555 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-54725552017-06-27 Value of macrobiopsies and transanal endoscopic microsurgery in the histological work-up of rectal neoplasms: A retrospective study Bökkerink, Guus M J van der Wilt, Gert-Jan de Jong, Dirk van Krieken, Han H J M Bleichrodt, Robert P de Wilt, Johannes H W Bremers, Andreas J A World J Gastrointest Oncol Retrospective Cohort Study AIM: To evaluate a step up approach: Taking macrobiopsies and performing excision biopsies in patients with suspected rectal cancer in which biopsies taken though the flexible endoscope showed benign histology. METHODS: Patients with a rectal neoplasm who underwent flexible endoscopy and biopsies were included. In case of benign biopsies rigid rectoscopy and macrobiopsies were employed. If this failed to prove malignancy, transanal endoscopic microsurgery (TEM) was used in a final effort to establish a certain preoperative diagnosis. The preoperative results were compared with the findings after surgical excision and follow up to calculate the reliability of this algorithm. RESULTS: One hundred and thirty-two patients were included. One hundred and ten patients with a carcinoma and 22 with an adenoma. Seventy-five of 110 carcinomas were proven malignant after flexible endoscopy. With the addition of rigid endoscopy and taking of macrobiopsies, this number increased to 89. Performing TEM excision biopsies further enlarged the number of proven malignancies to 100. CONCLUSION: The step-up approach includes taking macrobiopsies through the rigid rectoscope and performing excision biopsies using transanal endoscopic microsurgery in addition to flexible endoscopy. This approach, reduced the number of missed preoperative malignant diagnoses from 32% to 9%. Baishideng Publishing Group Inc 2017-06-15 2017-06-15 /pmc/articles/PMC5472555/ /pubmed/28656075 http://dx.doi.org/10.4251/wjgo.v9.i6.251 Text en ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Retrospective Cohort Study Bökkerink, Guus M J van der Wilt, Gert-Jan de Jong, Dirk van Krieken, Han H J M Bleichrodt, Robert P de Wilt, Johannes H W Bremers, Andreas J A Value of macrobiopsies and transanal endoscopic microsurgery in the histological work-up of rectal neoplasms: A retrospective study |
title | Value of macrobiopsies and transanal endoscopic microsurgery in the histological work-up of rectal neoplasms: A retrospective study |
title_full | Value of macrobiopsies and transanal endoscopic microsurgery in the histological work-up of rectal neoplasms: A retrospective study |
title_fullStr | Value of macrobiopsies and transanal endoscopic microsurgery in the histological work-up of rectal neoplasms: A retrospective study |
title_full_unstemmed | Value of macrobiopsies and transanal endoscopic microsurgery in the histological work-up of rectal neoplasms: A retrospective study |
title_short | Value of macrobiopsies and transanal endoscopic microsurgery in the histological work-up of rectal neoplasms: A retrospective study |
title_sort | value of macrobiopsies and transanal endoscopic microsurgery in the histological work-up of rectal neoplasms: a retrospective study |
topic | Retrospective Cohort Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5472555/ https://www.ncbi.nlm.nih.gov/pubmed/28656075 http://dx.doi.org/10.4251/wjgo.v9.i6.251 |
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