Kalade Andrius V, Desmond Paul V, Chen Robert Y
Department of Gastroenterology, St Vincent's Hospital, Melbourne, Victoria, Australia.
ANZ J Surg. 2006 Dec;76(12):1075-80. doi: 10.1111/j.1445-2197.2006.03945.x.
There is minimal prospective data on endoscopic ultrasound (EUS) experience in Australia. This study aimed to review the recent EUS experience of a single Australian tertiary hospital.
Data of all EUS carried out at St Vincent's Hospital, Melbourne, Australia were prospectively collected from August 2002 to September 2005. Patient demographics, indications, anatomical sites of EUS and fine-needle aspiration (FNA) were extracted from the database. A subset of 231 patients were involved in a prospective study to assess the clinical effect of EUS: with accuracy and outcomes data derived from surgical histology and pre-EUS and post-EUS questionnaires.
Five hundred and sixty-one procedures were carried out for 526 patients. Men comprised 57% (n = 300). Mean age was 60 years (range, 19-92 years). The indications were (i) oesophageal 30.7% (n = 172); (ii) pancreaticobiliary 29.6% (n = 166); (iii) mediastinal and lung 20.7% (n = 116); (iv) gastric 15.9% (n = 89); and (v) duodenal 3.2% (n = 18). Endoscopic ultrasound-guided FNA was carried out in 30.3% procedures (170/561). Overall EUS accuracy was 84% (55/67 patients) and EUS-guided FNA accuracy was 88% (28/32 patients). There were no major complications.
This is the largest reported Australian experience of EUS to date. Overall EUS was accurate, safe with no major complications or mortality and had useful outcomes. The role, expertise and accessibility of EUS in the Australian clinical setting are anticipated to continue to increase.
澳大利亚关于内镜超声(EUS)经验的前瞻性数据极少。本研究旨在回顾一家澳大利亚三级医院近期的EUS经验。
前瞻性收集2002年8月至2005年9月在澳大利亚墨尔本圣文森特医院进行的所有EUS数据。从数据库中提取患者人口统计学资料、适应证、EUS的解剖部位以及细针穿刺活检(FNA)情况。231例患者的一个亚组参与了一项前瞻性研究,以评估EUS的临床效果:准确性和结果数据来自手术组织学以及EUS术前和术后问卷。
对526例患者进行了561例操作。男性占57%(n = 300)。平均年龄为60岁(范围19 - 92岁)。适应证为:(i)食管30.7%(n = 172);(ii)胰胆29.6%(n = 166);(iii)纵隔和肺20.7%(n = 116);(iv)胃15.9%(n = 89);(v)十二指肠3.2%(n = 18)。30.3%的操作(170/561)进行了内镜超声引导下FNA。EUS总体准确率为84%(55/67例患者),EUS引导下FNA准确率为88%(28/32例患者)。无重大并发症。
这是迄今为止澳大利亚报道的最大规模EUS经验。总体而言,EUS准确、安全,无重大并发症或死亡,且有实用的结果。预计EUS在澳大利亚临床环境中的作用、专业技术和可及性将持续增加。