A novel approach: transumbilical endoscopic exploration and biopsy for patients with unknown ascites

Our plain-English summary of A novel approach: transumbilical endoscopic exploration and biopsy for patients with unknown ascites, by Y. Yang, W. Zhang, H. Xu, et al (Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a, 2012).

The study

• Authors: Y. Yang, W. Zhang, H. Xu, H. Lv, Z. Ma, D. Xue
• Journal: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a
• Published: 2012;22(7):691-4
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: The main surgical methods used for the diagnosis of unknown ascites are laparotomy, laparoscopic exploration, and natural orifice translumenal endoscopic surgery (NOTES). This article introduces a novel method: transumbilical endoscopic exploration and biopsy.

Patients And Methods: From September 2009 to January 2012, 11 patients with unknown ascites were scheduled for transumbilical endoscopic exploration and biopsy at the First Affiliated Hospital of Harbin Medical University, Harbin, China. After the patient underwent general anesthesia and artificial pneumoperitoneum, a 1.0-cm trocar was placed at the umbilical region. After initial observation of the whole peritoneal cavity with a laparoscope, a sterile endoscope (gastroscope) was put through the trocar. The surgeon regulated the depth of insertion of the endoscope and the direction of the trocar, while the endoscopic physician was in charge of turning the camera lens of the endoscope, controlling the biopsy forceps, irrigation, and suction. After exploration, four to six pieces of tissues were obtained for biopsy.

Results: These patients were diagnosed by endoscopic exploration and pathological examination: 3 cases were tuberculous peritonitis, 2 cases were malignant peritoneal mesotheliomas, 2 cases were peritoneal carcinomatosis, 1 case was a small intestinal tumor, 2 cases were advanced ovarian cancer, and 1 case was cirrhosis.

Conclusion: Transumbilical endoscopic exploration and biopsy is an easy, practical, and effective method for the diagnosis of unknown ascites.

In plain English

This article described a new way of finding the cause of fluid buildup in the abdomen (ascites) when the cause was unknown. It reported the method's use in 11 patients, 7 men and 4 women aged 36 to 72, at Harbin Medical University's First Affiliated Hospital in Harbin, China. Under general anesthesia, a 1.0-cm tube was placed through the navel and the abdomen was first viewed with a laparoscope. A sterilized flexible gastroscope was then passed through the same tube to look inside the abdomen and take four to six tissue samples. Tissue examination diagnosed 3 cases of tuberculous peritonitis, 2 of malignant peritoneal mesothelioma, 2 of peritoneal carcinomatosis, 1 small intestinal tumor, 2 of advanced ovarian cancer and 1 of cirrhosis. Six patients went on to chemotherapy. The authors wrote that the operation took as little as 20 to 30 minutes. The article did not discuss asbestos or any patient's exposure history. The authors concluded that the method was easy, practical and effective.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case series describing a new diagnostic technique (transumbilical endoscopic exploration and biopsy) in 11 patients
• Who was studied: 11 patients with ascites of unknown cause (7 male, 4 female, aged 36 to 72, average 53.82 years), First Affiliated Hospital of Harbin Medical University, Harbin, China, September 2009 to January 2012
• Exposure: No asbestos or other exposure was studied or reported. The article concerns a diagnostic procedure.
• Main results:
  • Among the 11 patients, the procedure and tissue examination diagnosed 3 cases of tuberculous peritonitis, 2 malignant peritoneal mesotheliomas, 2 peritoneal carcinomatosis and 1 small intestinal tumor
  • Among the 11 patients, the remaining diagnoses were 2 cases of advanced ovarian cancer and 1 case of cirrhosis
  • As follow-up treatment, 6 of the 11 patients underwent chemotherapy and 1 received hepatoprotective treatment; 3 were scheduled for antituberculosis treatment and 1 had small bowel tumor excision
  • The authors stated that the operation took as little as 20 to 30 minutes
• The authors' conclusion: The authors concluded that transumbilical endoscopic exploration and biopsy was an easy, practical and effective method for diagnosing ascites of unknown cause

Topics

Medical terms in this study, explained in our Lexicon: Biopsy, Ascites, Laparotomy, Peritoneal Cavity, Peritoneal Mesothelioma, Ovarian Cancer.

Related studies

• The role of peritoneal biopsy in the diagnosis of ascites — P.F. Jenkins, M.J. Ward (1980)
• Metastatic peritoneal mesothelioma in the setting of recurrent ascites: a case report — V. Samedi, S. White, et al. (2010)
• A Single-Center Experience: The Diagnostic Role of Peritoneoscopy in Patients with Exudative Ascites — B. Abaylı, G. Gençdal (2019)
• A Rare Case of Biphasic Malignant Peritoneal Mesothelioma with Refractory Ascites — T. Komaki, H. Urata, et al. (2017)
• Challenging and uncommon diagnosis of long-evolution ascites — M. Gravito-Soares, E. Gravito-Soares, et al. (2017)
• Metastasis of malignant peritoneal epithelioid mesothelioma in endoscopic gastric biopsy: a diagnostic pitfall — L. Daniele, A. Righi, et al. (2011)

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