Experimental endoscopy: objective evaluation of EUS needles
Experimental endoscopy: objective evaluation of EUS needles
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DOI：
10.1016/j.gie.2008.07.017
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发表时间：
2009-03-01
影响因子：
7.7
通讯作者：
Moriyasu, Fuminori
中科院分区：
文献类型：
--
作者：
Itoi, Takao;Itokawa, Fumihide;Moriyasu, Fuminori
背景：在临床环境中，超声医师认识到，不仅eus引导的FNA针的大小和特征，还有几个条件影响足够样本的获取。目的：结合3位超声探员对穿刺阻力的评价，利用台式模拟器提供标准化、可重复性、可比性的性能数据，比较19号全切、19号抽吸、22号抽吸和25号抽吸EUS针在不同条件下的特点。设计：实验室模拟，通过使用诊断性和治疗性EUS内镜，比较几种情况下（内窥镜平直和成角位置、内窥镜针尖成角和升降机的使用）对针头前进的阻力。这些不同的情况会对针头通过内窥镜的推进产生一系列的阻力。环境：研究实验室。主要结局测量：每根EUS针的推进阻力(N)的平均值（SD）。由超声单独评估针阻力，并将其分为5个级别（0（无阻力）至5（无法进针））。结果：超声检查提示针头进针阻力适中，对针头的压力阻力为5 N及以上，8 N及以上时阻力较大，当阻力为11 N及以上时无法进针。仪器评估显示，使用25号针和22号针时，在内镜直位时，针阻分别约小于2 N和3 N，使用内镜上斜或升降机时，19号针吸或直切针阻分别大于8 N和10 N。在成角内窥镜位下，19号针抽吸阻力大于10 N，上角时对trui -cut针阻力大于20 N。局限性：所有数据均为离体收集，临床有效性有待确定。结论：如果需要紧密成角，22号或25号eus引导的FNA针适合插入目标区域（Gastrointest Endosc 2009;69:509-16）。
Background: In the clinical setting, endosonographers acknowledge that not only the size and characteristics of EUS-guided FNA needles but also several conditions affect the acquisition of adequate samples.Objective: To compare the characteristics of the 19-gauge Tru-cut, 19-gauge aspiration, 22-gauge aspiration and 25-gauge aspiration EUS needles under several conditions by using a bench simulator designed to provide standardized, reproducible, comparative performance data in combination with evaluation by 3 endosonographers of needle-insertion resistance.Design: Laboratory simulations that compare resistance to needle advancement under several conditions (straight and angulated endoscope position, endoscopic tip angulation, and the use of the elevator) by using both diagnostic and therapeutic EUS scopes. These varied conditions cause a range of resistance to the advancement of the needle through the endoscope.Setting: Research laboratory.Main Outcome Measurement: The mean (SD) for advancement resistance (N) to each EUS needle. Needle resistance was evaluated individually by endosonographers and divided into 5 levels (0 [no resistance] to 5 (impossible for needle to be advanced]).Results: Endosonographers concluded that the needle-advancement resistance was moderate with a pressure resistance to the needle of 5 N or more and high at 8 N or more, and that it was impossible to advance the needle when the resistance to it was 11 N or more. Instrumentational evaluation showed chat, with the 25-gauge and 22-gauge needles, needle resistance was approximately less than 2 N and 3 N, respectivel in the straight endoscope position, the 19-gauge aspiration or Tru-cut needle resistance when Using Upward angulation of the endoscope or the elevator was more than 8 N and 10 N, respectively. In the angulated endoscope position, the resistance to the 19-gauge aspiration or Tru-cut needle When using Upward angulation was more than 10 N and 20 N, respectively.Limitations: All data were collected ex vivo, and clinical validity remains to be determined.Conclusions: The 22-gauge or 25-gauge EUS-guided FNA needles are suitable for insertion into the target regions if tight angulation is necessary (Gastrointest Endosc 2009;69:509-16.)