Improvements and innovations in endoscopic ultrasound guided fine needle aspiration

Huang, Jau‐Shyang; Chang, Kenneth J.

doi:10.1002/jhbp.232

Cited by 8 publications

(8 citation statements)

References 97 publications

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“…EUS-guided fine-needle biopsy (EUS-FNB) is an accurate and safe procedure for establishing a pathological diagnosis of pancreatic masses. [123456] However, although the high histological diagnostic accuracy has been reported, this still depends on endoscopic skills, pathological diagnostic skills, number of needle passes, and the presence of rapid onsite cytological evaluation (ROSE). [78910] The easy achievement of accuracy rate in pathological diagnosis approximated 100% with 1 or 2 passes is ideal for EUS-FNB.…”

Section: Introductionmentioning

confidence: 99%

A retrospective histological comparison of EUS-guided fine-needle biopsy using a novel franseen needle and a conventional end-cut type needle

et al. 2019

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Section: Introductionmentioning

confidence: 99%

A retrospective histological comparison of EUS-guided fine-needle biopsy using a novel franseen needle and a conventional end-cut type needle

et al. 2019

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“…Endoscopic ultrasound (EUS)-guided tissue sampling is a safe and accurate modality for diagnosing and staging lesions in and around the gastrointestinal tract 1 . It enables clinicians to obtain a tissue diagnosis during real-time imaging, using fine-needle aspiration (FNA) or fine-needle biopsy (FNB).…”

Section: Introductionmentioning

confidence: 99%

Mapping international practice patterns in EUS-guided tissue sampling: outcome of a global survey

et al. 2016

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Background and study aims: Although Endoscopic Ultrasound (EUS)-guided tissue sampling is widely used, the optimal sampling strategy remains subject of debate. We evaluated practice patterns within the international endosonographic community. Patients and methods: An online questionnaire was sent to 400 endosonographers from the United States, Europe, and Asia. Results: A total of 186 (47 %) endosonographers participated: United States 54 (29 %), Europe 85 (46 %), and Asia 47 (25 %). European (75 %) and Asian (84 %) respondents routinely check coagulation status, whereas US respondents only check on indication (64 %, P = 0.007). While propofol sedation is standard in the United States (83 %), conscious sedation is still widely used in Europe (52 %) and Asia (84 %, P < 0.001). Overall, the 22-gauge needle is most commonly used (52 %). For fine-needle aspiration (FNA) of solid pancreatic lesions, 22-gauge (45 %) and 25-gauge (49 %) needles are used equally. For fine-needle biopsy (FNB) of solid masses, the 25-gauge device is less favored than the 22-gauge FNA device (49 % versus 21 %). The 19-gauge needle is generally used for FNB of submucosal masses (62 %). Rapid on-site pathological evaluation (ROSE) is utilized more often by US (98 %) than by European and Asian respondents (51 %, P < 0.001). Cytolyt (52 %), formalin (15 %) and alcohol (15 %) are used for FNA specimen preservation in the United States and Europe, while saline (27 %) and alcohol (38 %) are widely used in Asia (P < 0.001). Conclusions: EUS-guided tissue sampling practices vary substantially within the international endosonographic community and differ considerably from recommendations expressed in guidelines. Because the clinical relevance of these variations is largely unknown, the outcome of this survey suggests a need for further studies.

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“…This then led to EUS-guided fine needle imaging with through-the-needle fiber optic probe combined with endomicroscopy in the evaluation of pancreatic cystic neoplasia[118,119,198-203]. EUS-guided FNA eventually become the mainstream modality for the tissue diagnosis of pancreatic cancer[185,204-209]. At this point, I coined a new term “Interventional EUS” in 1997[210] since we had moved away from mere diagnostic imaging to tissue acquisition and intervention.…”

Section: Endo-hepatologymentioning

confidence: 99%

Endoscopic foregut surgery and interventions: The future is now. The state-of-the-art and my personal journey

Chang

2019

WJG

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In this paper, I reviewed the emerging field of endoscopic surgery and present data supporting the contention that endoscopy can now be used to treat many foregut diseases that have been traditionally treated surgically. Within each topic, the content will progress as follows: “lessons learned”, “technical considerations” and “future opportunities”. Lessons learned will provide a brief background and update on the most current literature. Technical considerations will include my personal experience, including tips and tricks that I have learned over the years. Finally, future opportunities will address current unmet needs and potential new areas of development. The foregut is defined as “the upper part of the embryonic alimentary canal from which the pharynx, esophagus, lung, stomach, liver, pancreas, and part of the duodenum develop”. Foregut surgery is well established in treating conditions such as gastroesophageal reflux disease (GERD), achalasia, esophageal diverticula, Barrett’s esophagus (BE) and esophageal cancer, stomach cancer, gastric-outlet obstruction, and obesity. Over the past decade, remarkable progress in interventional endoscopy has culminated in the conceptualization and practice of endoscopic foregut surgery for various clinical conditions summarized in this paper. Regarding GERD, there are now several technologies available to effectively treat it and potentially eliminate symptoms, and the need for long-term treatment with proton pump inhibitors. For the first time, fundoplication can be performed without the need for open or laparoscopic surgery. Long-term data going out 5-10 years are now emerging showing extended durability. In respect to achalasia, per-oral endoscopic myotomy (POEM) which was developed in Japan, has become an alternative to the traditional Heller’s myotomy. Recent meta-analysis show that POEM may have better results than Heller, but the issue of post-POEM GERD still needs to be addressed. There is now a resurgence of endoscopic treatment of Zenker’s diverticula with improved technique (Z-POEM) and equipment; thus, patients are choosing flexible endoscopic treatment as opposed to open or rigid endoscopy options. In regard to BE, endoscopic submucosal dissection (ESD) which is well established in Asia, is now becoming more mainstream in the West for the treatment of BE with high grade dysplasia, as well as early esophageal cancer. In combination with all the ablation technologies (radiofrequency ablation, cryotherapy, hybrid argon plasma coagulation), the entire spectrum of Barrett’s and related dysplasia and early cancer can be managed predominantly by endoscopy. Importantly, in regard to early gastric cancer and submucosal tumors (SMTs) of the stomach, ESD and full thickness resection (FTR) can excise these lesions en-bloc and endoscopic suturing is now used to close large defects and perforations. For treatment of patients with malignant gastric outlet obstruction (GOO), endoscopic gastro-jejunostomy is now showing better results ...

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Improvements and innovations in endoscopic ultrasound guided fine needle aspiration

Cited by 8 publications

References 97 publications

A retrospective histological comparison of EUS-guided fine-needle biopsy using a novel franseen needle and a conventional end-cut type needle

A retrospective histological comparison of EUS-guided fine-needle biopsy using a novel franseen needle and a conventional end-cut type needle

Mapping international practice patterns in EUS-guided tissue sampling: outcome of a global survey

Endoscopic foregut surgery and interventions: The future is now. The state-of-the-art and my personal journey

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