Altonbary Ahmed Youssef, Hakim Hazem, Elkashef Wagdi
Department of Gastroenterology and Hepatology, Mansoura Specialized Medical Hospital, Mansoura University, Mansoura 35516, Egypt.
Department of Pathology, Mansoura University, Mansoura 35111, Egypt.
World J Gastrointest Endosc. 2020 Oct 16;12(10):355-364. doi: 10.4253/wjge.v12.i10.355.
Although endoscopic ultrasound (EUS) is now widely available and has an established role in adults, the utility of EUS and EUS-guided fine needle aspiration (EUS-FNA) in pediatrics is insufficiently described compared to adults and is supported by only a few studies.
To report the experience of a single tertiary center in the use of EUS and EUS-FNA in a pediatric population and to further assess its safety, feasibility, and clinical impact on management.
A retrospective study of 13 children (aged 18 years or younger) identified from our medical database was conducted. A retrospective review of demographic data, procedure indications, EUS findings, and the clinical impact of EUS on the subsequent management of these patients was performed.
During the 4-year study period, a total of 13 (1.7%) pediatric EUS examinations out of 749 EUS procedures were performed in our unit. The mean age of these 8 females and 5 males was 15.6 years (range: 6-18). Six of the 13 EUS examinations were pancreatobiliary (46.1%), followed by mediastinal 2/13 (15.4%), peri-gastric 2/13 (15.4%), abdominal lymphadenopathy 1/13 (7.7%), tracheal 1/13 (7.7%) and rectal 1/13 (7.7%). Overall, EUS-FNA was performed in 7 patients (53.8%) with a diagnostic yield of 100%. The EUS results had a significant impact on clinical care in 10/13 (77%) cases. No complications occurred in these patients during or after any of the procedures.
EUS and EUS-FNA in the pediatric population are safe, feasible, and have a significant clinical impact on the subsequent management; thus avoiding invasive and unnecessary procedures.
尽管内镜超声（EUS）目前已广泛应用，且在成人中具有明确作用，但与成人相比，EUS及EUS引导下细针穿刺活检（EUS-FNA）在儿科中的应用描述不足，仅有少数研究支持。
报告一家三级中心在儿科人群中使用EUS和EUS-FNA的经验，并进一步评估其安全性、可行性以及对治疗管理的临床影响。
对从我们的医学数据库中识别出的13名18岁及以下儿童进行回顾性研究。对人口统计学数据、操作指征、EUS检查结果以及EUS对这些患者后续治疗管理的临床影响进行回顾性分析。
在4年的研究期间，我们科室共进行了749例EUS检查，其中13例（1.7%）为儿科EUS检查。这8名女性和5名男性的平均年龄为15.6岁（范围：6 - 18岁）。13例EUS检查中，6例为胰胆疾病（46.1%），其次是纵隔疾病2/13（15.4%）、胃周疾病2/13（15.4%）、腹部淋巴结病1/13（7.7%）、气管疾病1/13（7.7%）和直肠疾病1/13（7.7%）。总体而言，7例患者（53.8%）接受了EUS-FNA，诊断阳性率为100%。EUS检查结果对10/13（77%）的病例的临床治疗有显著影响。这些患者在任何操作过程中及操作后均未发生并发症。
儿科人群中的EUS和EUS-FNA是安全、可行的，并且对后续治疗管理有显著的临床影响；从而避免了侵入性和不必要的操作。
