Complications associated with endobronchial ultrasound-guided transbronchial needle aspiration: a nationwide survey by the Japan Society for Respiratory Endoscopy.
Complications associated with endobronchial ultrasound-guided transbronchial needle aspiration: a nationwide survey by the Japan Society for Respiratory Endoscopy.
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DOI：
10.1186/1465-9921-14-50
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发表时间：
2013-05-10
影响因子：
5.8
通讯作者：
Ohmori K
中科院分区：
文献类型：
--
作者：
Asano F;Aoe M;Ohsaki Y;Okada Y;Sasada S;Sato S;Suzuki E;Semba H;Fukuoka K;Fujino S;Ohmori K
随着近年来支气管内超声引导下经支气管针吸活检术（EBUS-TBNA）的广泛使用，偶尔有与其使用相关的并发症报告。以前关于EBUS-TBNA的综述仅限于熟练操作者的研究，因此结果可能并不总是适用于最近的临床实践。为了评估EBUS-TBNA在日本肺癌分期和诊断中的安全性，日本呼吸内镜学会（JSRE）对其当前使用状况和使用相关并发症进行了全国性调查。在2011年1月至2012年6月期间，向520个经JSRE认证的设施邮寄了一份关于EBUS-TBNA的调查问卷。从455个设施（87.5%）获得了答复。在研究期间，在210家机构（46.2%）的7，345例病例中，使用凸形探头超声支气管镜对6，836处纵隔和肺门病变以及275处肺实质病变进行了EBUS-TBNA。32家机构发生了90例并发症。并发症发生率为1.23%（95%可信区间为0.97%~ 1.48%），其中出血为最常见的并发症（50例，0.68%）。感染并发症14例（0.19%）（纵隔炎7例，肺炎4例，心包炎1例，囊肿感染1例，败血症1例）。2例（0.03%）发生气胸，其中1例需要置管引流。关于并发症病例的结局，观察到14例住院时间延长，4例危及生命，1例死亡（重度脑梗死）（死亡率，0.01%）。超声支气管镜断裂98例（1.33%），发生率为31.9%;穿刺针断裂15例（0.20%），发生率为3.8%。尽管EBUS-TBNA相关并发症发生率较低，但观察到严重并发症，包括感染并发症，器械断裂发生率较高。由于EBUS-TBNA的使用在日本迅速扩大，因此应立即建立其安全性能的教育计划。
With the recent widespread use of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), there have been occasional reports on complications associated with its use. Previous reviews on EBUS-TBNA have been limited to studies by skilled operators, thus the results may not always be applicable to recent clinical practice. To assess the safety of EBUS-TBNA for the staging and diagnosis of lung cancer in Japan, a nationwide survey on its current usage status and complications associated with its use was conducted by the Japan Society for Respiratory Endoscopy (JSRE). A questionnaire about EBUS-TBNA performed between January 2011 and June 2012 was mailed to 520 JSRE-accredited facilities. Responses were obtained from 455 facilities (87.5%). During the study period, EBUS-TBNA was performed in 7,345 cases in 210 facilities (46.2%) using a convex probe ultrasound bronchoscope, for 6,836 mediastinal and hilar lesions and 275 lung parenchymal lesions. Ninety complications occurred in 32 facilities. The complication rate was 1.23% (95% confidence interval, 0.97%-1.48%), with hemorrhage being the most frequent complication (50 cases, 0.68%). Infectious complications developed in 14 cases (0.19%) (Mediastinitis, 7; pneumonia, 4; pericarditis, 1; cyst infection, 1; and sepsis, 1). Pneumothorax developed in 2 cases (0.03%), one of which required tube drainage. Regarding the outcome of the cases with complications, prolonged hospitalization was observed in 14 cases, life-threatening conditions in 4, and death in 1 (severe cerebral infarction) (mortality rate, 0.01%). Breakage of the ultrasound bronchoscope occurred in 98 cases (1.33%) in 67 facilities (31.9%), and that of the puncture needle in 15 cases (0.20%) in 8 facilities (3.8%). Although the complication rate associated with EBUS-TBNA was found to be low, severe complications, including infectious complications, were observed, and the incidence of device breakage was high. Since the use of EBUS-TBNA is rapidly expanding in Japan, an educational program for its safe performance should be immediately established.
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影响因子：
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作者：
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