Endoscopic Biopsy Yield in Upper Gastrointestinal Malignancies

Aravind, P (2015) Endoscopic Biopsy Yield in Upper Gastrointestinal Malignancies. Masters thesis, Stanley Medical College, Chennai.

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Abstract

AIM: Aim of this study is to find the optimal number of endoscopic biopsies needed to diagnose the upper gastrointestinal malignancies in the patient who undergoes endoscopic evaluation in General Surgery Department, Medical Gastroenterology Department, Surgical Gastroenterology Department endoscopic units of Stanley Medical College Hospital from may 2013 to august 2014. MATERIALS AND METHODS: This is an observational study conducted in Government Stanely Medical College Hospital from May 2013 to Aug 2014. Patients with upper gastrointestinal symptoms underwent esophagogastroduodenoscopy using forward viewing scope after getting the proper consent from them. procedure was done by well experienced endoscopist. In patients with suspected lesion of malignancy in the tract biopsies are taken. Number of biopsies aimed are eight and serially taken biopsies are labelled in four separate vials. each vial contains two consecutive samples in the 10% formal saline solution. Details of the site, extent, and type of the lesion were recorded. In case of haemorrhage or any complications the procedure is terminated with proper monitoring of patient until discharged. RESULTS: Upper gastro intestinal carcinomas are becoming increasingly common in Indian population accounting to the change in food habits and environmental changes occurring rapidly in the country. Of patients whom i included in my study from the total of fifty patients half of the patients had gastric carcinoma, others comprising esophageal carcinoma and periampullary carcinoma. There is a gradual increase in esophageal carcinoma incidence compared to the past incidence. periampullary carcinomas contribute to 12% of the total upper gastrointestinal malignancies. Gastric carcinomas account for the 52% of total malignancies in the upper gastrointestinal carcinomas. Esophageal carcinomas account for about 36% of carcinomas included in this study. CONCLUSION: Our study differs from that of others in that: (i) we evaluated more patients and the diagnostic yield of four biopsy specimens was 100%; (ii) two specimens were placed in each of the four vials rather than one, three, and three pieces in three vials; and (iii) Graham et al also performed salvage cytology while in our study cytological examination was not performed as this was not the aim of the study. (iv) We didn’t get all eight biopsies from everyone due to some complications (v) In this study we had only advanced lesions of malignancy. In conclusion, this study shows that four biopsy specimens are likely to yield a 100% diagnosis in advanced upper gastrointestinal malignancies. Whereas the endoscopic biopsy yield in the early stages of carcinomas should be evaluated in further studies.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Endoscopic Biopsy Yield ; Upper Gastrointestinal Malignancies.
Subjects: MEDICAL > General Surgery
Depositing User: Subramani R
Date Deposited: 22 Oct 2017 00:44
Last Modified: 22 Oct 2017 00:44
URI: http://repository-tnmgrmu.ac.in/id/eprint/3793

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