Are biopsies always necessary in upper and lower gastrointestinal endoscopy in children? A retrospective 10-year analysi
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ORIGINAL ARTICLE
Are biopsies always necessary in upper and lower gastrointestinal endoscopy in children? A retrospective 10-year analysis Rodrigo Corsato Scomparin 1,2 & Pedro Luiz Toledo De Arruda Lourencao 3 & Giovana Tuccile Comes 3 & Wilson Elias De Oliveira Junior 3 & Marcos Curcio Angelini 3 & Paulo Cezar Haddad de Amorim 3 & Simone Antunes Terra 4 & Maria Aparecida Marchesan Rodrigues 4 & Erika Veruska Paiva Ortolan 3 Received: 25 July 2020 / Revised: 15 September 2020 / Accepted: 9 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Little attention has been given to the efficiency and validity of performing routine endoscopic biopsies in normal areas in children. This study aimed to investigate the need to perform routine biopsies in upper gastrointestinal endoscopy (UDE) and colonoscopy in normal areas by comparing macroscopy and histology. It was a 10-year retrospective analysis with the inclusion of 761 UDEs and 177 colonoscopies. Considering all segments, UDEs showed false-positive result rates of 73.11% and falsenegative result rates of 14.34%. The histological results modified the initial management in 53.95% of patients. Considering all segments, colonoscopies showed false-positive result rates of 63.64% and false-negative result rates of 30.97%. The histological results modified the initial management in 34.45% of patients. Conclusion: If biopsies were obtained only in abnormal areas, the diagnosis would be lost in 53.95% of the patients in upper endoscopies and 85.7% of the colonoscopies, which justifies routine maintenance of biopsies in macroscopically normal areas in children. Keywords Pediatric . Colonoscopy . Upper digestive endoscopy . Histopathological analysis . Biopsies
Communicated by Peter de Winter * Rodrigo Corsato Scomparin [email protected]
Maria Aparecida Marchesan Rodrigues [email protected]
Pedro Luiz Toledo De Arruda Lourencao [email protected] Giovana Tuccile Comes [email protected] Wilson Elias De Oliveira Junior [email protected]
Erika Veruska Paiva Ortolan [email protected] 1
Endoscopy Unit, Botucatu Medical School, UNESP, São Paulo, Brazil
2
Faculdade de Medicina de Botucatu, Distrito de Rubia Jr s/n, Botucatu, SP 18618-687, Brazil
3
Pediatric Surgery and Endoscopy Unit, Botucatu Medical School, UNESP, São Paulo, Brazil
4
Pathology Department, Botucatu Medical School Hospital, UNESP, São Paulo, Brazil
Marcos Curcio Angelini [email protected] Paulo Cezar Haddad de Amorim [email protected] Simone Antunes Terra [email protected]
Eur J Pediatr
What is Known: • Little attention has been given to the efficiency and validity of endoscopic biopsies of normal areas during pediatric exams. • Only a few pediatric studies have correlated macroscopic and histological findings from endoscopic biopsies, and low sensitivity and specificity, as well as poor agreement, were reported. What is New: • Our study confirms the evidence that routine biopsies from macroscopically normal areas during upper and
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