Feasibility and safety of interventional radiology-guided biopsy for esophageal stenosis.

Abstract

Background: Endoscopic clamp biopsy is generally performed to confirm the pathological diagnosis of esophageal stenosis. However, it might be challenging in patients with severe esophageal stenosis. Hence, we aimed to investigate the feasibility and safety of interventional radiology-guided clamp biopsy under fluoroscopy for diagnosing esophageal stenosis.

Methods: The clinical data of 81 patients aged 39-89 (mean age 67.4 ± 10.5) years with esophageal stenosis whose pathological tissues were obtained by interventional radiology-guided forceps biopsy at our treatment center were retrospectively analyzed; 35.8% (29/81) patients had esophageal space-occupying stenosis and 64.2% (52/81) had esophagogastric anastomotic stenosis. The detection rate of esophageal stenosis, and operation-related complications were analyzed.

Results: About 75.3% (61/81) patients could not tolerate or refused endoscopic examination; the remaining 24.7% (20/81) underwent endoscopic examination, but their pathological specimens could not be obtained through the stenosis segment. The technical success rate of interventional radiology-guided clamp biopsy was 100%, and the mean duration of operation was 7.8 ± 4.2 minutes. No serious operation-related complications were observed. Histological examination showed that 35.8% (29/81) patients had malignant tumor and 64.2% (52/81) had benign tumor. Interventional radiology-guided biopsy had a better detection rate compared with gastroscopic biopsy (P < 0.001, χ2 = 64.64).

Conclusion: Interventional radiology-guided clamp biopsy is a new esophageal biopsy technique that is minimally invasive, safe, and rapid, with a low rate of missed diagnosis and low requirements regarding the patients' condition. Thus, it is a complementary or auxiliary diagnostic method in cases where the traditional endoscopic approach fails.