The safety of fine-needle aspiration guided by endoscopic ultrasound: a prospective study
The safety of fine-needle aspiration guided by endoscopic ultrasound: a prospective study
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DOI：
10.1055/s-2007-995336
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发表时间：
2008-03-01
期刊：
影响因子：
9.3
通讯作者：
Raimondo, M.
中科院分区：
文献类型：
--
作者：
Al-Hadclad, M.;Wallace, M. B.;Raimondo, M.
背景和研究目的：细针抽吸（FNA）通常与内窥镜超声（EUS）手术结合进行。与 FNA 相关的并发症发生率被认为较低，但需要通过前瞻性研究进一步评估。 患者和方法：共有 483 名在 12 个月内连续接受 EUS 引导 FNA 的患者前瞻性地纳入该研究。对患者进行术后并发症筛查，包括腹痛、恶心、呕吐和胃肠道出血。 EUS-FNA 后立即评估并发症，30 天后通过电话评估这 30 天期间的急诊室和医生办公室就诊或住院情况。结果：从 414 名患者 (86%) 中获得了完整信息。第一天就有七名患者出现并发症。其中 5 名患者意外入院：两名患者因胰腺囊肿细针穿刺活检后出现腹痛而接受观察；一名患者因纵隔淋巴结 FNA 后出现胸痛而被观察；腹腔淋巴结细针穿刺活检后对两名患者进行监测，其中一名患者出现短暂发热，另一名患者出现自限性黑便。这五名患者均在入院 24 小时内出院，没有人需要输血，也没有人出现任何胰腺炎或感染的证据。另外两名患者前往急诊科就诊，但在经过适当评估后因服用口服止痛药而出院。到第 30 天，已有 6 名患者因原发病死亡。 EUS-FNA 没有出现意外的发病率或死亡率。结论：对于在大容量学术中心接受 EUS 的患者，FNA 是一种安全的干预措施，术后并发症发生率较低。
Background and study aims: Fine-needle aspiration (FNA) is commonly performed in conjunction with endoscopic ultrasound (EUS) procedures. The complication rate associated with FNA is considered to be low but requires further evaluation with prospective studies.Patients and methods: A total of 483 consecutive patients who underwent EUS-guided FNA over a 12-month period were prospectively enrolled in the study. The patients were screened for postprocedural complications, including abdominal pain, nausea, vomiting, and gastrointestinal bleeding. Complications were assessed immediately after EUS-FNA and 30 days later with a telephone call, when inquiries were made about emergency room and physician's office visits or hospitalizations during this 30-day period.Results: Complete information was obtained from 414 patients (86%). Complications occurred in seven patients during the first day. Five of these patients had unplanned admissions to hospital: two patients were observed because they had abdominal pain after FNA of pancreatic cysts; one patient was observed because they developed chest pain after mediastinal lymph node FNA; and two patients were monitored after celiac node FNA, one with a transient fever and one with self-limited melena. All five of these patients were discharged within 24 hours of admission, none required blood transfusion, and none showed any evidence of pancreatitis or infection. Two other patients visited the emergency department but were discharged on oral analgesics after appropriate evaluation. By day 30 six patients had died as a result of their primary disease process. There was no unexpected morbidity or mortality attributable to the EUS-FNA.Conclusions: FNA is a safe intervention in patients undergoing EUS in a high-volume academic center, with a low postprocedural complication rate.