Fine needle aspiration using forward-viewing endoscopic ultrasonography
Fine needle aspiration using forward-viewing endoscopic ultrasonography
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DOI：
10.1055/s-0030-1256508
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发表时间：
2011-09-01
期刊：
影响因子：
9.3
通讯作者：
Koizumi, W.
中科院分区：
文献类型：
--
作者：
Kida, M.;Araki, M.;Koizumi, W.
背景和研究目的：一个原型前视仪器已开发用于治疗性内窥镜超声（EUS）引导细针穿刺（FNA）。我们有机会使用这种前瞻性的回声内窥镜，并研究其临床实用性，主要用于诊断EUS-FNA.Patients和方法：原型前瞻性的回声内窥镜被用于15个月之间的2006年11月和2010年3月，在一个研究组，包括47个连续的患者。对38例患者进行了诊断性EUS-FNA，并将前视设备的诊断准确性与疾病和穿刺路径匹配的参考患者的前视回波内窥镜的诊断准确性进行了比较。治疗性EUS在9例患者（假性囊肿引流6;腹腔神经节神经松解术，胆道引流，胰管引流，在每个）。结果：诊断EUS-FNA提供了正确的诊断在97.4%（37/38例），这是没有显着不同的参考患者的94.7%（36/38）。被认为难以用内窥镜进入的病变，如位于穹窿或胰头的病变，或与狭窄相关的病变，很容易被穿刺，位于胰体或胰尾或肝门的病变也很容易被穿刺。所有9例接受治疗性EUS手术的患者均获得成功。47例患者没有任何并发症。结论：一个前瞻性的回声内窥镜，允许目标网站被穿刺更垂直，以最小的努力，可用于诊断EUS-细针穿刺，这可能是有利的，根据网站的目标病变。
Background and study aim: A prototype forward-viewing instrument has been developed for therapeutic endoscopic ultrasound (EUS)guided fine needle aspiration (FNA). We had the opportunity to use this forward-viewing echo endoscope and to study its clinical usefulness, mainly for diagnostic EUS-FNA.Patients and methods: The prototype forward-viewing echo endoscope was used for 15 months between November 2006 and March 2010, in a study group comprising 47 consecutive patients. Diagnostic EUS-FNA was done in 38 patients and the diagnostic accuracy of the forward-viewing device was compared with that from an oblique-viewing echo endoscope in reference patients who were matched by disease and puncture route. Therapeutic EUS was done in nine patients (pseudocyst drainage in six; celiac ganglia neurolysis, biliary drainage, and pancreatic duct drainage in one each).Results: Diagnostic EUS-FNA provided a correct diagnosis in 97.4% (37/38 patients), which was not significantly different from the 94.7% (36/38) in the reference patients. Lesions considered difficult to access with an oblique-viewing scope, such as those located at the fornix, or the head of the pancreas, or associated with strictures, were easily punctured, as were those located at the body or tail of the pancreas or at the porta hepatis. Treatment was successful in all nine patients who underwent therapeutic EUS procedures. None of the 47 patients had any complications.Conclusions: A forward-viewing echo endoscope that allows target sites to be punctured more perpendicularly with minimal effort, can be used for diagnostic EUS-FNA and this may be advantageous, depending on the site of target lesions.