title: Tissue diagnosis of GI subepithelial tumor only through Trucut biopsy under a forward-viewing endoscope: applicability as newer diagnostic modality.
abstract: Trucut biopsy (TCB) has been proposed to overcome the limitations of endoscopic ultrasonography (EUS)-guided fine-needle aspiration for the pathologic diagnosis of upper gastrointestinal (GI) subepithelial tumor (SET); however, it can be difficult to perform because the Trucut biopsy needle is very stiff. Although technical failures have been reported with the use of TCB, recently the forward-viewing echoendoscope showed a high diagnostic accuracy. We hypothesized that TCB under a conventional forward-viewing endoscope can be applied with higher yield of tissue diagnosis.
  
  
  
  To evaluate the feasibility of TCB under a forward-looking endoscopy without cumbersome EUS guidance, we introduced a 19-gauge TCB needle into the working channel of a conventional upper endoscope in 27 patients with GI SET to make tissue diagnosis. Prospectively collected data were analyzed, including technical success rate, pathologic result, and adverse events.
  
  
  
  Twenty-seven patients with GI SET (18 esophageal tumors and nine gastric tumors) underwent TCB under a forward-looking endoscope. All procedures were performed safely without any TCB-related complications. Subsequently, histopathology examination revealed gastrointestinal stromal tumors (GISTs) in three cases and leiomyomas in 21 cases. Histologic assessment was completed in 24 out of 27 patients (88.9 %) because tissue obtained from three patients, whose tumors were located in the stomach, was not sufficient for the pathologic diagnosis.
  
  
  
  TCB using a conventional forward-viewing endoscope without EUS guidance provided an excellent pathologic diagnosis of upper GI SET.
authors.affiliation: Digestive Disease Center, CHA Bundang Medical Center, CHA University, 59 Yatapro, Bundang-gu, Seongnam-si, Korea.
authors.forename: Weon Jin
authors.initials: WJ
authors.lastname: Ko
authors.affiliation: Digestive Disease Center, CHA Bundang Medical Center, CHA University, 59 Yatapro, Bundang-gu, Seongnam-si, Korea.
authors.forename: Ga Won
authors.initials: GW
authors.lastname: Song
authors.affiliation: Digestive Disease Center, CHA Bundang Medical Center, CHA University, 59 Yatapro, Bundang-gu, Seongnam-si, Korea.
authors.forename: Ki Baik
authors.initials: KB
authors.lastname: Hahm
authors.affiliation: Digestive Disease Center, CHA Bundang Medical Center, CHA University, 59 Yatapro, Bundang-gu, Seongnam-si, Korea.
authors.forename: Sung Pyo
authors.initials: SP
authors.lastname: Hong
authors.affiliation: Digestive Disease Center, CHA Bundang Medical Center, CHA University, 59 Yatapro, Bundang-gu, Seongnam-si, Korea. cjy6695@dreamwiz.com.
authors.forename: Joo Young
authors.initials: JY
authors.lastname: Cho
authors.affiliation: Digestive Disease Center, Soonchunhyang University Hospital, Seoul, Korea.
authors.forename: Jun-Hyung
authors.initials: JH
authors.lastname: Cho
authors.affiliation: Department of Pathology, Soonchunhyang University Hospital, Seoul, Korea.
authors.forename: So Young
authors.initials: SY
authors.lastname: Jin
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D019723:Endoscopes; D016099:Endoscopy, Gastrointestinal; D004938:Esophageal Neoplasms / Q000473:pathology*; D005240:Feasibility Studies; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology; D006801:Humans; D007889:Leiomyoma / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology*
keywords: Forward-viewing endoscope; Subepithelial tumor; Trucut biopsy