Rana Surinder Singh, Sharma Ravi, Gupta Rajesh
Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160 012, India.
Department of Surgery, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160 012, India.
Indian J Gastroenterol. 2018 May;37(3):231-234. doi: 10.1007/s12664-018-0861-x. Epub 2018 Jun 19.
Pleural effusion is a common finding both in patients with benign and malignant diseases of pleura and lung with diagnostic thoracentesis establishing the diagnosis in the majority of cases. The diagnostic thoracentesis can be done either blindly or under the guidance of ultrasound or computed tomography. However, minimal pleural effusion is difficult to sample even under image guidance. Endoscopic ultrasound (EUS) is known to detect smaller volume of pleural effusion and, thus, can help in guiding thoracentesis.
To analyze the safety and efficacy of EUS-guided diagnostic thoracentesis in patients with undiagnosed minimal pleural effusion retrospectively.
Retrospective analysis of the data of patients with minimal pleural effusion, who underwent EUS-guided transesophageal diagnostic thoracentesis over last 2 years, was performed.
Thirteen patients (11 male; mean age 46.7 ± 16.2 years) with undiagnosed minimal pleural effusion underwent successful EUS-guided transesophageal diagnostic thoracentesis using a 22-G needle. Seven (53%) patients had fever on presentation whereas two presented with cough and loss of appetite. Eight to 54 mL fluid was aspirated with an attempt to completely empty the pleural cavity. There were no complications of the procedure.
EUS-guided diagnostic thoracentesis is a safe and effective alternative for evaluating patients with minimal pleural effusion.
胸腔积液在胸膜和肺部良性及恶性疾病患者中均很常见，大多数情况下通过诊断性胸腔穿刺术可确立诊断。诊断性胸腔穿刺术可盲目进行，也可在超声或计算机断层扫描引导下进行。然而，即使在影像引导下，微量胸腔积液也难以采样。已知内镜超声（EUS）能检测到更小体积的胸腔积液，因此有助于引导胸腔穿刺术。
回顾性分析EUS引导下诊断性胸腔穿刺术在未确诊的微量胸腔积液患者中的安全性和有效性。
对过去2年中接受EUS引导下经食管诊断性胸腔穿刺术的微量胸腔积液患者的数据进行回顾性分析。
13例（11例男性；平均年龄46.7±16.2岁）未确诊的微量胸腔积液患者成功接受了EUS引导下经食管诊断性胸腔穿刺术，使用的是22G穿刺针。7例（53%）患者就诊时发热，2例出现咳嗽和食欲不振。抽取了8至54毫升液体，试图完全排空胸腔。该操作无并发症发生。
EUS引导下诊断性胸腔穿刺术是评估微量胸腔积液患者的一种安全有效的替代方法。
