Endoscopy Unit, Valinhos Medical Center, Valinhos, São Paulo, Brazil.
Universidade de São Paulo Hospital das Clínicas, Serviço de Endoscopia Gastrointestinal, Departamento de Gastroenterologia, São Paulo, Brazil.
Dis Colon Rectum. 2022 Feb 1;65(2):e80-e84. doi: 10.1097/DCR.0000000000002333.
Curvilinear array ultrasound transducers enable tissue sampling and have therapeutic capabilities. Nevertheless, colonic intubation and maneuvering with these transducers is technically challenging and is therefore typically limited to the rectosigmoid area. This retrospective cohort study aimed to evaluate the safety, feasibility, and diagnostic yield of colonoscopic ultrasound-guided fine-needle aspiration in deep colonic intubation.
The impact of this innovation is to enable tissue sampling of colonic and extracolonic lesions guided by endoscopic ultrasound.
TECHNOLOGY, MATERIALS, AND METHODS: Curvilinear array ultrasound is used in the evaluation of luminal and extraluminal colonic diseases. Thirteen patients underwent colonoscopic ultrasound with a curvilinear array ultrasound endoscope in a single center for subepithelial lesions, cancer staging, and extracolonic lesions from July 2015 to February 2021. Endosonography was performed using an Olympus EU-ME1 and GF-UCT 180 with a 5-12MHz curvilinear array transducer. The primary outcome was the percentage of patients who were successfully scanned with the endoscopic ultrasound. The secondary outcomes included the success rate of fine-needle aspiration, the diagnostic yield of the tissue samples, and the adverse events related to the procedure.
A total of 13 female patients underwent colonoscopic ultrasound. All patients (100%, 13/13) were successfully scanned. Fine-needle aspiration was deemed necessary and successfully performed in 100% (5/5) of the patients. Tissue samples collected by fine-needle aspiration resulted in a diagnostic yield of 60%, and no adverse events resulted from this intervention.
This study demonstrates the feasibility of performing colonoscopic ultrasound with a curvilinear array transducer. Fine-needle aspiration for subepithelial, colonic, and extracolonic lesions is feasible and safe in this setting with no adverse events reported in our study.
Future research should be directed toward validating colonoscopic ultrasound with a curvilinear array transducer technique in prospective randomized trials. Studies evaluating the feasibility and safety of endoscopic ultrasound-guided interventions in the colon, such as abscess drainage and enteral anastomosis, should be considered.
弯曲阵列超声换能器可进行组织取样，并且具有治疗能力。然而，将这些换能器插入结肠并进行操作在技术上具有挑战性，因此通常仅限于直肠乙状结肠区域。本回顾性队列研究旨在评估结肠镜超声引导下细针抽吸在结肠深部插管中的安全性、可行性和诊断效果。
该创新点在于使内镜超声引导下的结直肠和结外病变组织取样成为可能。
技术、材料和方法： 弯曲阵列超声用于评估腔内腔外结肠疾病。 2015 年 7 月至 2021 年 2 月，在一家单中心，13 名患者接受了弯曲阵列超声内镜进行结肠镜超声检查，用于评估黏膜下病变、癌症分期和结外病变。 超声内镜使用 Olympus EU-ME1 和 GF-UCT 180 进行，配备 5-12MHz 弯曲阵列换能器。主要结局是接受内镜超声检查的患者百分比。次要结局包括细针抽吸的成功率、组织样本的诊断效果和与该程序相关的不良事件。
共有 13 名女性患者接受了结肠镜超声检查。所有患者（100%，13/13）均成功扫描。在 100%（5/5）的患者中认为有必要进行细针抽吸，并且成功进行了细针抽吸。 通过细针抽吸收集的组织样本的诊断效果为 60%，并且该干预措施未导致任何不良事件。
本研究表明使用弯曲阵列换能器进行结肠镜超声检查是可行的。在这种情况下，对黏膜下、结肠和结外病变进行细针抽吸是可行且安全的，在我们的研究中没有报告不良事件。
未来的研究应该致力于在前瞻性随机试验中验证使用弯曲阵列换能器技术的结肠镜超声检查。应该考虑评估结肠镜超声引导下干预的可行性和安全性的研究，例如脓肿引流和肠内吻合术。
