内镜超声引导下细针抽吸的基本技术：导丝和抽吸的作用。
Basic techniques in endoscopic ultrasound-guided fine-needle aspiration: Role of a stylet and suction.
机构信息
Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Center, Aurora, CO, USA ; Division of Gastroenterology and Hepatology, Veterans Affairs Medical Center, Denver, CO, USA.
出版信息
Endosc Ultrasound. 2014 Jan;3(1):17-21. doi: 10.4103/2303-9027.123008.
Abstract
There are several variables that have been studied to optimize various outcomes of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) such as quality and adequacy of specimens, diagnostic yield of malignancy, accuracy and overall efficiency. Using an evidence-based approach, the objectives of this review are to discuss two key aspects of EUS-FNA: (a) Use of a stylet and (b) use of suction. Level 1 evidence available from randomized controlled trials demonstrates that the use of a stylet during EUS-FNA has no impact on the diagnostic yield of malignancy or the quality of specimens. Air flushing in a slow, controlled fashion is superior to reinsertion of a stylet to express EUS-FNA aspirates. The use of suction should be considered during EUS-FNA of pancreatic masses. However, data from a randomized controlled trial suggest that suction should not be used during EUS-FNA of lymph nodes as it increases bloodiness of specimens obtained and has no impact on the overall diagnostic yield.
摘要
有几个变量已经被研究用于优化内镜超声引导下细针抽吸术（EUS-FNA）的各种结果，如标本的质量和充足性、恶性肿瘤的诊断率、准确性和整体效率。本综述采用循证方法，旨在讨论 EUS-FNA 的两个关键方面：（a）使用导丝和（b）使用抽吸。来自随机对照试验的 1 级证据表明，EUS-FNA 中使用导丝不会影响恶性肿瘤的诊断率或标本的质量。缓慢、受控的空气冲洗优于重新插入导丝以表达 EUS-FNA 抽吸物。在胰腺肿块的 EUS-FNA 中应考虑使用抽吸。然而，来自随机对照试验的数据表明，在 EUS-FNA 淋巴结时不应使用抽吸，因为它会增加获得的标本的血液含量，并且对整体诊断率没有影响。
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本文引用的文献
1
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Gastrointest Endosc. 2013 May;77(5):745-51. doi: 10.1016/j.gie.2012.12.009. Epub 2013 Feb 21.
2
Objective assessment of an algorithmic approach to EUS-guided FNA and interventions.
Gastrointest Endosc. 2013 May;77(5):739-44. doi: 10.1016/j.gie.2012.11.029. Epub 2013 Jan 29.
3
Comparison of endoscopic ultrasonography-guided fine-needle aspiration cytology results with and without the stylet in 3364 cases.
Dig Endosc. 2013 May;25(3):303-7. doi: 10.1111/j.1443-1661.2012.01374.x. Epub 2012 Sep 19.
4
Diagnostic yield of malignancy during EUS-guided FNA of solid lesions with and without a stylet: a prospective, single blind, randomized, controlled trial.
Gastrointest Endosc. 2012 Aug;76(2):328-35. doi: 10.1016/j.gie.2012.03.1395. Epub 2012 Jun 12.
5
Appropriate use of GI endoscopy.
Gastrointest Endosc. 2012 Jun;75(6):1127-31. doi: 10.1016/j.gie.2012.01.011.
6
Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline.
Endoscopy. 2011 Oct;43(10):897-912. doi: 10.1055/s-0030-1256754. Epub 2011 Aug 12.
7
A prospective, single-blind, randomized, controlled trial of EUS-guided FNA with and without a stylet.
Gastrointest Endosc. 2011 Jul;74(1):58-64. doi: 10.1016/j.gie.2011.02.015. Epub 2011 Apr 23.
8
A comparative study of endoscopic ultrasound guided fine needle aspiration with and without a stylet.
Dig Dis Sci. 2011 Aug;56(8):2409-14. doi: 10.1007/s10620-011-1608-z. Epub 2011 Feb 17.
9
A prospective comparison of endoscopic ultrasound-guided fine needle aspiration results obtained in the same lesion, with and without the needle stylet.
Endoscopy. 2010 Nov;42(11):900-3. doi: 10.1055/s-0030-1255676. Epub 2010 Aug 19.
10
Randomized controlled trial of endoscopic ultrasound-guided fine-needle sampling with or without suction for better cytological diagnosis.
Scand J Gastroenterol. 2009;44(4):499-504. doi: 10.1080/00365520802647392.
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