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The Application of Core Needle Biopsy Through the Trocar Hole in the Surgical Operation of Endoscopically Unresectable Giant Colon Polyps: A Systematic Review Study

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Abstract

Introduction

The study aimed to investigate the application of core needle biopsy through the trocar hole during surgery on endoscopically unresectable giant colon polyps.

Methods

The clinical data of 51 patients with endoscopically unresectable giant colon polyps from May 2016 to May 2020 were retrospectively analyzed. The primary observational outcomes were two comparative analyses of pathologic results, using the kappa index: comparison of the pathologic results from the preoperative colonoscopy and the postoperative pathologic results and comparison of the intraoperative pathologic results from core needle biopsy of the intestinal wall and the postoperative pathologic results. The secondary observational outcomes were duration of needle biopsy, operation duration, volume of intraoperative hemorrhage, rate of postoperative wound infection, rate of abdominal cavity infection, length of stay, and number and positivity of lymph node dissections after laparoscopic radical resection of colon cancer.

Results

Poor consistency was found between the preoperative (colonoscopy) and postoperative pathologic results, with kappa = 0.222 (i.e., kappa < 0.4), P < 0.05. However, good consistency was found between the intraoperative (core needle biopsy) and postoperative pathologic results, with kappa = 0.923 (i.e., kappa ≥ 0.75), P < 0.05. The postoperative pathologic results were as follows: 7 cases of adenomatous polyps of the colon, 12 cases of low-grade intraepithelial neoplasia, 12 cases of high-grade intraepithelial neoplasia, and 25 cases of invasive colon cancer. There was no incision infection, no abdominal cavity infection or formation of an abdominal abscess, no anastomotic leakage, and no death for any of the 51 patients. Postoperative complications occurred in two cases (3.92%).

Conclusion

Biopsy through the trocar hole during laparoscopic surgery produced highly accurate pathologic results and was a fast, safe, and effective diagnostic method. Pathologic results from intraoperative biopsy could accurately determine the nature of colon polyps and provide a basis for choosing an appropriate surgical scheme.

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Acknowledgements

We thank the participants of the study.

Funding

No funding or sponsorship was received for this study or publication of this article. The Rapid Service Fee was funded by the authors.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosures

The authors Chun-bo Kang, Xu-bin Li, Shiyang Hou, Jie Zhang, Xiao-qian Chi, Hai-feng Shan, Qi-jun Zhang, and Tie-jun Liu have nothing to disclose.

Compliance with Ethics Guidelines

This study was conducted in accordance with the Declaration of Helsinki. This study was conducted with approval from the Ethics Committee of Beijing Rehabilitation Hospital of Capital Medical University. Ethics committee reference number: 2016bkky-008. Written informed consent was obtained from all participants.

Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Author notes

  1. The authors Chun-bo Kang and Xu-bin Li contributed equally to this study.

Authors and Affiliations

  1. General Surgery Department, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, 100144, China

    Chun-bo Kang, Xu-bin Li, Shiyang Hou, Jie Zhang, Xiao-qian Chi, Hai-feng Shan, Qi-jun Zhang & Tie-jun Liu

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  1. Chun-bo Kang
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Correspondence to Tie-jun Liu.

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Kang, Cb., Li, Xb., Hou, S. et al. The Application of Core Needle Biopsy Through the Trocar Hole in the Surgical Operation of Endoscopically Unresectable Giant Colon Polyps: A Systematic Review Study. Adv Ther 38, 2662–2672 (2021). https://doi.org/10.1007/s12325-021-01635-8

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