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An automated spring-loaded needle for endoscopic ultrasound-guided abdominal paracentesis in cancer patients

World Journal of Gastrointestinal Endoscopy 2014年第2期6卷 55-59页

作者： Rei Suzuki Atsushi Irisawa Manoop S Bhutani Takuto Hikichi Tadayuki Takagi Goro Shibukawa Ai Sato Masaki Sato Tsunehiko Ikeda Ko Watanabe Jun Nakamura Srinadh Annangi Kazuhiro Tasaki Katsutoshi Obara Hiromasa Ohira Department of Gastroenterology and Rheumatology Division of Medicine Fukushima Medical University School of Medicine Department of Gastroenterology Fukushima Medical University Aizu Medical Center Department of Gastroenterology Hepatology and Nutrition the University of Texas MD Anderson Cancer Center Department of Endoscopy Fukushima Medical University Hospital Department of Pathology Fukushima Medical University Hospital

AIM: To evaluate the feasibility of using an automatedspring-loaded needle device for endoscopic ultrasound(EUS)-guided abdominal paracentesis(EUS-P) to see if this would make it easier to puncture the mobile and lax gastric wall for ***: The EUS database and electronic medical records at Fukushima Medical University Hospital were searched from January 2001 to April 2011. Patients with a history of cancer and who underwent EUS-P using an automated spring-loaded needle device with a 22-gauge puncture needle were included. The needle was passed through the instrument channel and advanced through the gastrointestinal wall under EUS guidance into the echo-free space in the abdominal cavity and ascitic fluid was collected. The confirmed diagnosis of malignant ascites included positive cytology and results from careful clinical observation for at least 6 mo in patients with negative cytology. The technical success rate, cytology results and complications were ***: We found 11 patients who underwent EUS-P with an automated spring-loaded needle device. In 4 cases, ascites was revealed only with EUS but not in other imaging modalities. EUS-P was done in 7 other cases because there was minimal ascitic fluid and no safe window for percutaneous abdominal aspiration. Ascitic fluid was obtained in all cases by EUS-P. The average amount aspirated was 14.1 mL(range 0.5-38 mL) and that was sent for cytological exam. The etiology of ascitic fluid was benign in 5 patients and malignant in 6. In all cases, ascitic fluid was obtained with the first needle pass. No procedure-related adverse effects ***: EUS-P with an automated springloaded needle device is a feasible and safe method for ascites evaluation.

关键词： ascetic fluid Malignancy Endoscopic ultrasound Paracentesis Fine needle aspiration

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