The Yield of Routine Tissue Sampling in Pediatric Gastrointestinal Endoscopy

Objectives: Societies’ guidelines suggest routine tissue sampling in all children undergoing esophagogastroduodenoscopy and ileocolonoscopy, even in the absence of visible endoscopy abnormalities. We aimed to determine the agreement between endoscopic and histopathological findings in pediatric endo...

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Published inJournal of pediatric gastroenterology and nutrition Vol. 76; no. 4; pp. 489 - 493
Main Authors Anafy, Adi, Amir, Achiya Z., Brazowski, Eli, Weintraub, Yael, Yerushalmy Feler, Anat, Moran‐Lev, Hadar, Dali Levy, Margalit, Ziv‐Baran, Tomer, Cohen, Shlomi, Ben‐Tov, Amir
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Published United States Lippincott Williams & Wilkins 01.04.2023
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Abstract Objectives: Societies’ guidelines suggest routine tissue sampling in all children undergoing esophagogastroduodenoscopy and ileocolonoscopy, even in the absence of visible endoscopy abnormalities. We aimed to determine the agreement between endoscopic and histopathological findings in pediatric endoscopy and to assess the yield of routine biopsies from all sites. Methods: Since January 2019, our endoscopy institute protocol has included routine biopsies sampling from the esophagus, stomach, duodenum, ileum, and colon in all diagnostic procedures. Agreement between tests was done using the kappa coefficient (κ). The study included all endoscopies performed during 2019. Results: In total, 541 diagnostic endoscopies were done during the study period with 434 (80%) esophagogastroduodenoscopy and 107 (20%) were ileocolonoscopy. Compared to histology, endoscopic findings performance were: esophagus—sensitivity 33%, specificity 98%; stomach—sensitivity 60%, specificity 89%; duodenum—sensitivity 50%, specificity 97%; duodenal bulb—sensitivity 47%, specificity 89%; terminal ileum—sensitivity 82%, specificity 100%; colon—sensitivity 84%, specificity 96%. Assessment of concordance between endoscopic and histopathologic findings reveals an overall low level of agreement in esophagogastroduodenoscopy (κ of 0.39, 0.51, 0.53, and 0.24 for the esophagus, stomach, duodenal second part, and bulb, respectively), and good agreement in ileocolonoscopy (κ of 0.88 and 0.81 for the ileum and colon, respectively). Conclusions: Endoscopy findings are highly specific for histologic pathology, whereas the absence of findings correlates poorly with histologic findings. Ileocolonoscopy shows better agreement than esophagogastroduodenoscopy. Our data support routine tissue sampling in pediatric endoscopy.
AbstractList Societies' guidelines suggest routine tissue sampling in all children undergoing esophagogastroduodenoscopy and ileocolonoscopy, even in the absence of visible endoscopy abnormalities. We aimed to determine the agreement between endoscopic and histopathological findings in pediatric endoscopy and to assess the yield of routine biopsies from all sites. Since January 2019, our endoscopy institute protocol has included routine biopsies sampling from the esophagus, stomach, duodenum, ileum, and colon in all diagnostic procedures. Agreement between tests was done using the kappa coefficient ( κ ). The study included all endoscopies performed during 2019. In total, 541 diagnostic endoscopies were done during the study period with 434 (80%) esophagogastroduodenoscopy and 107 (20%) were ileocolonoscopy. Compared to histology, endoscopic findings performance were: esophagus-sensitivity 33%, specificity 98%; stomach-sensitivity 60%, specificity 89%; duodenum-sensitivity 50%, specificity 97%; duodenal bulb-sensitivity 47%, specificity 89%; terminal ileum-sensitivity 82%, specificity 100%; colon-sensitivity 84%, specificity 96%. Assessment of concordance between endoscopic and histopathologic findings reveals an overall low level of agreement in esophagogastroduodenoscopy ( κ of 0.39, 0.51, 0.53, and 0.24 for the esophagus, stomach, duodenal second part, and bulb, respectively), and good agreement in ileocolonoscopy ( κ of 0.88 and 0.81 for the ileum and colon, respectively). Endoscopy findings are highly specific for histologic pathology, whereas the absence of findings correlates poorly with histologic findings. Ileocolonoscopy shows better agreement than esophagogastroduodenoscopy. Our data support routine tissue sampling in pediatric endoscopy.
OBJECTIVESSocieties' guidelines suggest routine tissue sampling in all children undergoing esophagogastroduodenoscopy and ileocolonoscopy, even in the absence of visible endoscopy abnormalities. We aimed to determine the agreement between endoscopic and histopathological findings in pediatric endoscopy and to assess the yield of routine biopsies from all sites. METHODSSince January 2019, our endoscopy institute protocol has included routine biopsies sampling from the esophagus, stomach, duodenum, ileum, and colon in all diagnostic procedures. Agreement between tests was done using the kappa coefficient ( κ ). The study included all endoscopies performed during 2019. RESULTSIn total, 541 diagnostic endoscopies were done during the study period with 434 (80%) esophagogastroduodenoscopy and 107 (20%) were ileocolonoscopy. Compared to histology, endoscopic findings performance were: esophagus-sensitivity 33%, specificity 98%; stomach-sensitivity 60%, specificity 89%; duodenum-sensitivity 50%, specificity 97%; duodenal bulb-sensitivity 47%, specificity 89%; terminal ileum-sensitivity 82%, specificity 100%; colon-sensitivity 84%, specificity 96%. Assessment of concordance between endoscopic and histopathologic findings reveals an overall low level of agreement in esophagogastroduodenoscopy ( κ of 0.39, 0.51, 0.53, and 0.24 for the esophagus, stomach, duodenal second part, and bulb, respectively), and good agreement in ileocolonoscopy ( κ of 0.88 and 0.81 for the ileum and colon, respectively). CONCLUSIONSEndoscopy findings are highly specific for histologic pathology, whereas the absence of findings correlates poorly with histologic findings. Ileocolonoscopy shows better agreement than esophagogastroduodenoscopy. Our data support routine tissue sampling in pediatric endoscopy.
Objectives: Societies’ guidelines suggest routine tissue sampling in all children undergoing esophagogastroduodenoscopy and ileocolonoscopy, even in the absence of visible endoscopy abnormalities. We aimed to determine the agreement between endoscopic and histopathological findings in pediatric endoscopy and to assess the yield of routine biopsies from all sites. Methods: Since January 2019, our endoscopy institute protocol has included routine biopsies sampling from the esophagus, stomach, duodenum, ileum, and colon in all diagnostic procedures. Agreement between tests was done using the kappa coefficient (κ). The study included all endoscopies performed during 2019. Results: In total, 541 diagnostic endoscopies were done during the study period with 434 (80%) esophagogastroduodenoscopy and 107 (20%) were ileocolonoscopy. Compared to histology, endoscopic findings performance were: esophagus—sensitivity 33%, specificity 98%; stomach—sensitivity 60%, specificity 89%; duodenum—sensitivity 50%, specificity 97%; duodenal bulb—sensitivity 47%, specificity 89%; terminal ileum—sensitivity 82%, specificity 100%; colon—sensitivity 84%, specificity 96%. Assessment of concordance between endoscopic and histopathologic findings reveals an overall low level of agreement in esophagogastroduodenoscopy (κ of 0.39, 0.51, 0.53, and 0.24 for the esophagus, stomach, duodenal second part, and bulb, respectively), and good agreement in ileocolonoscopy (κ of 0.88 and 0.81 for the ileum and colon, respectively). Conclusions: Endoscopy findings are highly specific for histologic pathology, whereas the absence of findings correlates poorly with histologic findings. Ileocolonoscopy shows better agreement than esophagogastroduodenoscopy. Our data support routine tissue sampling in pediatric endoscopy.
Author Moran‐Lev, Hadar
Ben‐Tov, Amir
Weintraub, Yael
Yerushalmy Feler, Anat
Dali Levy, Margalit
Cohen, Shlomi
Anafy, Adi
Amir, Achiya Z.
Brazowski, Eli
Ziv‐Baran, Tomer
AuthorAffiliation the Department of Pathology, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
From the Pediatric Gastroenterology Institute, Dana-Dwek Children’s Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Copyright 2023 by European Society for European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition
Lippincott Williams & Wilkins
Copyright © 2023 by European Society for European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.
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  article-title: The value of obtaining colonic mucosal biopsies of grossly normal tissue in pediatric patients.
  publication-title: J Pediatr Gastroenterol Nutr
  doi: 10.1097/MPG.0000000000003038
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    fullname: Glass
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  publication-title: J Pediatr Gastroenterol Nutr
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Snippet Objectives: Societies’ guidelines suggest routine tissue sampling in all children undergoing esophagogastroduodenoscopy and ileocolonoscopy, even in the...
Societies' guidelines suggest routine tissue sampling in all children undergoing esophagogastroduodenoscopy and ileocolonoscopy, even in the absence of visible...
OBJECTIVESSocieties' guidelines suggest routine tissue sampling in all children undergoing esophagogastroduodenoscopy and ileocolonoscopy, even in the absence...
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SubjectTerms agreement
biopsy
Biopsy - methods
Child
children
Duodenum - pathology
endoscopy
Endoscopy, Gastrointestinal - methods
Humans
Retrospective Studies
Sensitivity and Specificity
Stomach - diagnostic imaging
Stomach - pathology
Title The Yield of Routine Tissue Sampling in Pediatric Gastrointestinal Endoscopy
URI https://onlinelibrary.wiley.com/doi/abs/10.1097%2FMPG.0000000000003710
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https://www.ncbi.nlm.nih.gov/pubmed/36689933
https://search.proquest.com/docview/2769374471
Volume 76
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