How Good Is Single-Incision Needle-Knife Biopsy in Diagnosing Gastrointestinal Subepithelial Tumors?

Tissue sampling of subepithelial lesions (SELs) is needed to determine the diagnosis, malignant potential, and management of these lesions. Endoscopic ultrasound-guided fine needle aspiration and/or biopsy (EUS-FNA and/or FNB) is the most common procedure for tissue acquisition. Bite-on-bite and single-incision with needle-knife (SINK) biopsies have emerged as alternative diagnostic approaches for tissue acquisition, eliminating the need for EUS. This systematic review and meta-analysis evaluated the technical and diagnostic success (primary outcomes) as well as the adverse events (secondary outcomes) of SINK biopsy. 

The authors of this study searched numerous databases and performed a meta-analysis of 7 studies with a total of 219 SINK biopsy procedures. The technical success rate of SINK was 98.1% (95% confidence interval [CI], 94.9%-99.3%; P=.000; I2=0.0%), and the diagnostic success rate was 87.9% (95% CI, 82.6%-91.7%; P=.000; I2=0.0%). Immunohistochemical staining was successfully performed in 88.3% of patients (95% CI, 78.7%-93.9%; P=.000; I2=3.5%). Adverse events occurred in 7.5% of patients (95% CI, 4.3%-12.7%; P=.00; I2=7.2%), with bleeding being the most common (9 cases of bleeding, 1 case of abdominal pain).