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内镜超声引导下细针抽吸活检的组织学诊断在日本三级中心的不良事件:多中心回顾性研究。

Adverse events of endoscopic ultrasound-guided fine-needle aspiration for histologic diagnosis in Japanese tertiary centers: Multicenter retrospective study.

机构信息

Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi, Japan.

Department of Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi, Japan.

出版信息

Dig Endosc. 2021 Nov;33(7):1146-1157. doi: 10.1111/den.13912. Epub 2021 Jan 15.

Abstract

BACKGROUND AND AIMS

Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is used for the histopathological diagnosis of any type of gastrointestinal disease. Few adverse events are experienced with this procedure; however, the actual rate of adverse events remains unclear. This study aimed to clarify the current status of cases that experienced adverse events related to the EUS-FNA procedure used for histopathologic diagnoses.

METHODS

A retrospective analysis of cases with EUS-FNA-related adverse events in Japanese tertiary centers was conducted by assessing the following clinical data: basic case information, FNA technique, type of procedural adverse events, and prognosis.

RESULTS

Of the 13,566 EUS-FNA cases overall, the total number of cases in which adverse events related to EUS-FNA occurred was 234. The incidence of EUS-FNA-related adverse events was ~1.7%. Bleeding and pancreatitis cases accounted for ~49.1% and 26.5% of all adverse events, respectively. Bleeding was the most common adverse event with only seven cases requiring blood transfusion. In cases with neuroendocrine tumors, pancreatitis was the most frequent adverse event. Needle tract seeding because of EUS-FNA was observed during the follow-up period in only ~0.1% of cases with pancreatic cancer. There was no mortality because of adverse events caused by EUS-FNA.

CONCLUSIONS

This study revealed that the adverse events-related EUS-FNA for histopathologic diagnoses were not severe conditions, and had low incidence.

摘要

背景与目的

内镜超声引导下细针抽吸术(EUS-FNA)用于胃肠道疾病的组织病理学诊断。该操作极少发生不良事件,但实际不良事件发生率尚不清楚。本研究旨在阐明与用于组织病理学诊断的 EUS-FNA 相关的不良事件的病例现状。

方法

通过评估以下临床数据,对日本三级中心 EUS-FNA 相关不良事件病例进行回顾性分析:基本病例信息、FNA 技术、程序不良事件类型和预后。

结果

在 13566 例 EUS-FNA 病例中,与 EUS-FNA 相关的不良事件总例数为 234 例。EUS-FNA 相关不良事件的发生率约为 1.7%。出血和胰腺炎分别占所有不良事件的约 49.1%和 26.5%。出血是最常见的不良事件,仅有 7 例需要输血。对于神经内分泌肿瘤,胰腺炎是最常见的不良事件。在随访期间,仅约 0.1%的胰腺癌患者因 EUS-FNA 出现针道种植。没有因 EUS-FNA 引起的不良事件导致死亡。

结论

本研究表明,用于组织病理学诊断的 EUS-FNA 相关不良事件并不严重,且发生率较低。

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