1.Micro-Biopsy Forceps in the Assessment of Peritoneal Carcinomatosis: A Possible New Indication?
Cecilia BINDA ; Emanuele DABIZZI ; Emanuele SINAGRA ; Adele FORNELLI ; Luca SARAGONI ; Vincenzo CENNAMO ; Andrea ANDERLONI ; Carlo FABBRI
Clinical Endoscopy 2021;54(4):613-617
Peritoneal carcinomatosis (PC) is defined as a metastatic involvement of the peritoneum by several other primary sites and it is characterized by a marked worsening of prognosis, with limited treatment opportunities. Subsequently, PC should be ruled out before any invasive treatment is administered. A new through-the-needle micro-biopsy forceps (MF) was recently introduced that permits micro-histology cores. In this case series, we evaluated the feasibility of MF in the assessment of PC to complete patient diagnostic work-ups. Five consecutive patients referred for endoscopic ultrasound staging were sampled using MF. Sampling was feasible in all patients with a technical success of 100%. No adverse events were reported in any cases. This technique was feasible and safe with a technical success rate of 100%. It permitted sampling of peritoneal irregularity, obtained high-quality tissue fragments in all cases, and enabled an additional assessment, i.e., immunohistochemical staining.
2.Micro-Biopsy Forceps in the Assessment of Peritoneal Carcinomatosis: A Possible New Indication?
Cecilia BINDA ; Emanuele DABIZZI ; Emanuele SINAGRA ; Adele FORNELLI ; Luca SARAGONI ; Vincenzo CENNAMO ; Andrea ANDERLONI ; Carlo FABBRI
Clinical Endoscopy 2021;54(4):613-617
Peritoneal carcinomatosis (PC) is defined as a metastatic involvement of the peritoneum by several other primary sites and it is characterized by a marked worsening of prognosis, with limited treatment opportunities. Subsequently, PC should be ruled out before any invasive treatment is administered. A new through-the-needle micro-biopsy forceps (MF) was recently introduced that permits micro-histology cores. In this case series, we evaluated the feasibility of MF in the assessment of PC to complete patient diagnostic work-ups. Five consecutive patients referred for endoscopic ultrasound staging were sampled using MF. Sampling was feasible in all patients with a technical success of 100%. No adverse events were reported in any cases. This technique was feasible and safe with a technical success rate of 100%. It permitted sampling of peritoneal irregularity, obtained high-quality tissue fragments in all cases, and enabled an additional assessment, i.e., immunohistochemical staining.
3.Impact of contrast dye submucosal pre-lifting on cold snare resection of small polyps: an Italian randomized observational trial
Ramona SCHIUMERINI ; Paola BACCARINI ; Adele FORNELLI ; Davide ALLEGRI ; Francesca LODATO ; Alessia GAZZOLA ; Pasquale APOLITO ; Nunzio P. LONGO ; Anna M. POLIFEMO ; Franca PATRIZI ; Federica BUONFIGLIOLI ; Stefania GHERSI ; Marco BASSI ; Liza CERONI ; Antonella GHETTI ; Giulio FONTI ; Vincenzo CENNAMO
Clinical Endoscopy 2025;58(2):291-302
Background/Aims:
Small polyps are the most frequently detected lesions during colonoscopy, with an incomplete resection rate of 6.8% to 15.9%. This study aimed to improve small polyp cold snare resection radicality using submucosal contrast dye pre-lifting (PL+CSP).
Methods:
This single-center, prospective, randomized controlled trial compared the standard cold snare polypectomy technique (PL-CSP) with PL+CSP to evaluate endoscopic and histological complete resection rates, adverse events, procedural times, and polyp retrieval failure rates.
Results:
In 143 patients consecutively enrolled, 186 small polyps were detected and randomly assigned following a 1:1 ratio to the PL-CSP (n=97, 51.6%) and PL+CSP (n=90, 48.4%) techniques. Endoscopic (p=0.97) and histologic (p=0.23) complete resection rates did not differ significantly even in univariate analysis. The intraprocedural bleeding rate was significantly higher in the PL+CSP group as confirmed by the univariate analysis (35.8% vs. 8.3%, p<0.001). The polyps retrieval failure rates were similar (p=0.83). Procedural time was significantly longer for PL+CSP (median time, 75 vs. 45 seconds; p<0.001), without impacting colonoscopy withdrawal time (p=0.215).
Conclusions
PL+CSP of small polyps did not improve endoscopic and histological complete resection rates and polyp sample retrieval. PL+CSP had higher rates of intraprocedural bleeding and was “time-consuming”.
4.Impact of contrast dye submucosal pre-lifting on cold snare resection of small polyps: an Italian randomized observational trial
Ramona SCHIUMERINI ; Paola BACCARINI ; Adele FORNELLI ; Davide ALLEGRI ; Francesca LODATO ; Alessia GAZZOLA ; Pasquale APOLITO ; Nunzio P. LONGO ; Anna M. POLIFEMO ; Franca PATRIZI ; Federica BUONFIGLIOLI ; Stefania GHERSI ; Marco BASSI ; Liza CERONI ; Antonella GHETTI ; Giulio FONTI ; Vincenzo CENNAMO
Clinical Endoscopy 2025;58(2):291-302
Background/Aims:
Small polyps are the most frequently detected lesions during colonoscopy, with an incomplete resection rate of 6.8% to 15.9%. This study aimed to improve small polyp cold snare resection radicality using submucosal contrast dye pre-lifting (PL+CSP).
Methods:
This single-center, prospective, randomized controlled trial compared the standard cold snare polypectomy technique (PL-CSP) with PL+CSP to evaluate endoscopic and histological complete resection rates, adverse events, procedural times, and polyp retrieval failure rates.
Results:
In 143 patients consecutively enrolled, 186 small polyps were detected and randomly assigned following a 1:1 ratio to the PL-CSP (n=97, 51.6%) and PL+CSP (n=90, 48.4%) techniques. Endoscopic (p=0.97) and histologic (p=0.23) complete resection rates did not differ significantly even in univariate analysis. The intraprocedural bleeding rate was significantly higher in the PL+CSP group as confirmed by the univariate analysis (35.8% vs. 8.3%, p<0.001). The polyps retrieval failure rates were similar (p=0.83). Procedural time was significantly longer for PL+CSP (median time, 75 vs. 45 seconds; p<0.001), without impacting colonoscopy withdrawal time (p=0.215).
Conclusions
PL+CSP of small polyps did not improve endoscopic and histological complete resection rates and polyp sample retrieval. PL+CSP had higher rates of intraprocedural bleeding and was “time-consuming”.
5.Impact of contrast dye submucosal pre-lifting on cold snare resection of small polyps: an Italian randomized observational trial
Ramona SCHIUMERINI ; Paola BACCARINI ; Adele FORNELLI ; Davide ALLEGRI ; Francesca LODATO ; Alessia GAZZOLA ; Pasquale APOLITO ; Nunzio P. LONGO ; Anna M. POLIFEMO ; Franca PATRIZI ; Federica BUONFIGLIOLI ; Stefania GHERSI ; Marco BASSI ; Liza CERONI ; Antonella GHETTI ; Giulio FONTI ; Vincenzo CENNAMO
Clinical Endoscopy 2025;58(2):291-302
Background/Aims:
Small polyps are the most frequently detected lesions during colonoscopy, with an incomplete resection rate of 6.8% to 15.9%. This study aimed to improve small polyp cold snare resection radicality using submucosal contrast dye pre-lifting (PL+CSP).
Methods:
This single-center, prospective, randomized controlled trial compared the standard cold snare polypectomy technique (PL-CSP) with PL+CSP to evaluate endoscopic and histological complete resection rates, adverse events, procedural times, and polyp retrieval failure rates.
Results:
In 143 patients consecutively enrolled, 186 small polyps were detected and randomly assigned following a 1:1 ratio to the PL-CSP (n=97, 51.6%) and PL+CSP (n=90, 48.4%) techniques. Endoscopic (p=0.97) and histologic (p=0.23) complete resection rates did not differ significantly even in univariate analysis. The intraprocedural bleeding rate was significantly higher in the PL+CSP group as confirmed by the univariate analysis (35.8% vs. 8.3%, p<0.001). The polyps retrieval failure rates were similar (p=0.83). Procedural time was significantly longer for PL+CSP (median time, 75 vs. 45 seconds; p<0.001), without impacting colonoscopy withdrawal time (p=0.215).
Conclusions
PL+CSP of small polyps did not improve endoscopic and histological complete resection rates and polyp sample retrieval. PL+CSP had higher rates of intraprocedural bleeding and was “time-consuming”.