УДК 616-072.1-06
M.S. Burdyukov1,2, A.M. Nechipay2, I.N. Yurichev1,2, B.I. Dolgushin1, G.V. Ungiadze1
1N.N. Blokhin Russian Cancer Research Center, Moscow
2Russian Medical Academy of Postgraduate Education of Russian Ministry of Healthcare, Moscow
Burdyukov M.S. ― Cand. Med. Sc., Senior Researcher of Endoscopy Department of the N.N. Blokhin Russian Cancer Research Center, Associate Professor of Endoscopy Department of Russian Medical Academy of Postgraduate Education of Russian Ministry of Healthcare
23 Kashirskoe highway, Moscow, Russian Federation, 115478, tel. +7-903-686-40-54, e-mail: burdyukov@rambler.ru
Abstract. Endoscopic Ultrasonography (EUS) and Endoscopic Ultrasonography with Fine-Needle Aspiration (EUS-FNA) as an invasive methods are associated with a chance of adverse events. The unique properties of the echoendoscop and its ability to acquire tissue outside of the gastrointestinal lumen impart risks that are not associated with routine endoscopic procedures. Increased risks are connected to the safety of the needle insertion route, presence of blood disorders in patient etc. In this review we discuss frequency of adverse events related to EUS-FNA of solid masses.
Aim ― to evaluate the complications related to EUS and EUS-FNA procedures in analyzed a 10-year trend (2006-2016).
Methods. In a retrospective single-center case-series, 1241 men and 1059 women, a total of 2300 patients (median age, 58 years), undergoing diagnostic EUS were included. Among a small cohort of 581 (25.3%) patients, EUS-FNA was applied.
Results. Adverse events associated with the procedure were reported in 6 (0.26% out of total EUS, n=2300) of cases, out of them 5 cases were related to EUS-FNA (0.52% out of total EUS-FNA, n=581). Among them 1 esophageal perforation (0,043% out of total EUS, n=2300), 2 cases of bleeding (0.086% out of total EUS, n=2300; 0.34% out of total EUS-FNA, n=581), 3 cases of infectious complications (0.13% out of total EUS, n=2300; 0.52% out of total EUS-FNA, n=581) were reportedly revealed.
Conclusion. EUS and EUS-FNA have emerged is a generally safe and effective modality. However, adverse events do develop. Knowledge of potential complications secondary to EUS and EUS-FNA, their expected frequency, and their associated risk factors may help to minimize their occurrence.
Key words: endoscopic ultrasonography, fine-needle aspiration, adverse events.
REFERENCES
1. Silvis S.E., Nebel O., Rogers G., Sugawa C., Mandelstam P. Endoscopic complications. Results of the 1974 American Society for Gastrointestinal Endoscopy Survey. JAMA, 1976, 235, p. 928.
2. Zubarik R., eisen G., Mastrpietro C. Prospective analysis of complications 30 days after outpatient upper endoscopy. Am. J. Gastroenterol, 1999, 94, p. 1539.
3. Guidelines on Safety and Sedation for Endoscopic Procedures (BSG Guidelines: Safety and Sedation for Endoscopic Procedures, 2003, available at: at www.bsg.org.uk).
4. Guidelines for Decontamination of Equipment for Gastrointestinal Endoscopy (BSG Guidelines: Guidelines For Decontamination of Equipment for Gastrointestinal Endoscopy, 2003, available at: at www.bsg.org.uk).
5. Quine M.A., Bell G.D., McCloy R.F. et al. Prospective audit of upper gastrointestinal endoscopy in two regions of England: safety, staffing and sedation, methods. Gut, 1995, 36, pp. 462-467.
6. Scoping our practice. The 2004 Report of the National Confidential Enquiry into Patient Outcome and Death, available at: www.ncepod.org.uk
7. Guideline on the Management of Anticoagulation and Antiplatelet Therapy for Endoscopic Procedures’ Eisen G.M., Baron T.H., Dominitz J.A., Faigel D.O., Goldstein J.L., Johanson J.F., Mallery J.S., Raddawi H.M., Vargo J.J. 2nd, Waring J.P., Fanelli R.D., Wheeler-Harbough J.; American Society for Gastrointestinal Endoscopy. Guideline on the management of anticoagulation and antiplatelet therapy for endoscopic procedures. Gastrointest Endosc, 2002, 55, pp. 775-779.
8. Chan M.F. Complications of upper gastrointestinal endoscopy. Gastrointest Endosc. Clin. N. Am, 1996, Apr, 6 (2), pp. 287-303.
9. O’Toole D., Palazzo L., Arotçarena R. et al. Assessment of complications of EUS-guided fine-needle aspiration. Gastrointest Endosc, 2001, 53, pp. 470-4.
10. Annema J.T., Veselic M., Versteegh M.I., Rabe K.F. Mediastinitis caused by EUS-FNA of a bronchogenic cyst. Endoscopy, 2003, 35, pp. 791-3.
11. O’Toole D., Palazzo L., Arotçarena R. et al. Assessment of complications of EUS-guided fine-needle aspiration. Gastrointest Endosc, 2001, 53, pp. 470-4.
12. Ryan A.G., Zamvar V., Roberts S.A. Iatrogenic candidal infection of a mediastinal foregut cyst following endoscopic ultrasound-guided fine-needle aspiration. Endoscopy, 2002, 34 (10), pp. 838-839.
13. Grandval P., Picon M., Coste P. et al. Infection of submucosal tumor after endosonography-guided needle biopsy. Gastroenterol Clin. Biol, 1999, 23 (5), pp. 566-568.
14. ten Berge J., Hoffman B.J., Hawes R.H. et al. EUS-guided fine-needle aspiration of the liver: indications, yield and safety, based on an international survey of 167 cases. Gastrointest Endosc, 2002, 55, pp. 859-62.
15. Ardengh J.C., Lopes C.V. et al. Diagnosis of pancreatic tumors by endoscopic ultrasound-guided fine-needle aspiration. World J. Gastroenterol, 2007, 13 (22), pp. 3112-3116.
16. Micames C., Jowell P.S., White R. et al. Lower frequency of peritoneal carcinomatosis in patients with pancreatic cancer diagnosed by EUS-guided FNA vs. percutaneous FNA. Gastrointest Endosc, 2003, 58, pp. 690-695.
17. Varadarajulu S., Fraig M., Schmulewitz N. et al. Comparison of EUS-guided 19-gauge trucut-needle biopsy with EUS-guided fine-needle aspiration. Endoscopy, 2004, 36, pp. 397-401.
18. Larghi A., Verna E.C., Stavropoulos S.N. et al. EUS-guided trucut-needle biopsies in patients with solid pancreatic masses: a prospective study. Gastrointest Endosc, 2004, 59, pp. 185-190.
19. Gress F.G., Hawes R.H., Savides T.J. et al. Endoscopic ultrasound-guided fine-needle aspiration biopsy using linear array and radial scanning endosonography. Gastrointest Endosc, 1997, 45, pp. 243-50.
20. Williams D.B., Sahai A.V., Aabakken L. et al. Endoscopic ultrasound-guided fine-needle aspiration biopsy: a large single centre experience. Gut, 1999, 44, pp. 720-726.
21. Annema J.T., Veselic M., Versteegh M.I., Rabe K.F. Mediastinitis caused by EUS-FNA of a bronchogenic cyst. Endoscopy, 2003, 35, pp. 791-3.
22. Janssen J., Konig K., Knop-Hammad V. et al. Frequency of bacteremia after linear EUS of the upper GI tract with and without FNA. Gastrointest Endosc, 2004, 59 (3), pp. 339-344.
23. Fornari F., Civardi G., Cavanna L. et al. Complications of ultrasonically guided fine-needle abdominal biopsy. Results of a multicenter Italian study and review of the literature. The Cooperative Italian Study Group. Scand. J. Gastroenterol, 1989, 24, pp. 949-955.
24. Kai-Xuan Wang, Qi-Wen Ben, Zhen-Dong Jin et al. Assessment of morbidity and mortality associated with EUS-guided FNA: a systematic review. Gastrointest Endosc, 2011, 73, pp. 283-90.
25. Affi A., Vazquez-Sequeiros E., Norton I.D. et al. Utility of EUS in the evaluation of cystic pancreatic lesions. Gastrointest Endosc, 2002, 56, pp. 543-5.
26. Burdyukov M.S., Nechipay A.M., Yurichev I.N. et al. Guidelines for the implementation of endoscopic ultrasonography in the lumen of the upper gastrointestinal tract in a mode Convex scan and fine needle puncture under its control. Klinicheskaya endoskopiya, 2012, no. 4 (36), pp. 2-27 (in Russ.).