Purpose
To investigate the clinical effectivity of (EUS) guided interventions in our owngroup of patients. To summarizethe complications and main drawbacks of the methods used. To compare the EUS navigation with other imaging guidance used in our department. Two main approaches and several types of interventions were studied:Transvaginal approachTransvaginal pelvic biopsy (n=24)Transvaginal pelvic drainage (n=1)Transrectal approachTransrectal pelvic drainage (n=9)Transrectal prostatic abscess drainage (n=5)Transrectal pelvic biopsy(n=9)Transrectal prostatic biopsy (n=705) - not analysed in this paperModern trends of gynecooncologic treatment necessarily need the morphologic verification of the tumorous...
Methods and Materials
A mechanical probe5-7.5 MHzwas used with circular and end-firing gray-scale imaging connected to Prima(SIEMENS 1997). Dopplerometric studies were not reliable with this apparatus. Due to the analog character of the imager, the documentation was stored in a usual PC by means of a graber in the form of pictures and videos. A metallic removable bioptic adapter, consisting of spoon-form channel , connected with the probe body by a metallic bridge anchor, was usedto guide the interventions.The preparation of the patient consistsof administration ofwide-spectral antibiotics one...
Results
33 biopsies (FNAB or core-cut)and 15 abscess drainages(perirectal, prostatic) were carried out. No complication related to the intervention was encountered. The abscess drainage brought definitive clinical success in 90% of the cases, the biopsy was conclusive in 87%.
Conclusion
The authors´ experience with transrectal or transvaginal interventions in the pelvic region guided by endosonography (EUS), dealing mainly with abscess drainages and biopsies, was reviewed.The technique of the intervention was described. The clinical results from the period 2000-2009 are discussed.Disadvantagesof punctional biopsy•Higher proportion of inconclusive histologic or cytologic results•Histopathologic finding often non-committal (sometimes needlessly ?)•Logistically difficult to directly convert into surgery•Periprocedural histology or cytologyoften not possible•In the case of serious complication (none in authors´ group), the treatment could be problematic (radiointervention?)Disadvantages of surgical biopsy•Higher risk...
References
1. Fritscher-Ravens A. (2008) EUS-guided NOTES interventions. Gastrointest Endosc Clin N Am. 18(2):297-3142. Jenssen C, Faiss S, Nürnberg D. (2008) Complications of endoscopic ultrasound and endoscopic ultrasound-guided interventions - results of a survey among German centers. Z Gastroenterol. 46(10):1177-843. Jhala NC, Eltoum IA, Eloubeidi MA, Meara R, Chhieng DC, Crowe DR, Jhala D. (2007) Providing on-site diagnosis of malignancy on endoscopic-ultrasound-guided fine-needle aspirates: should it be done? Ann Diagn Pathol. 11(3):176-814. Morales L, Neven P, Timmerman D, Wildiers H, Konstantinovic ML, Christiaens MR, Tan PN,...
Personal Information
Radiodiagnostic Department, University Hospital, Pilsen - Bory organises 5th interdisciplinary symposium withinternational participation ENDOSONOGRAPHY andPOSTPROCESSINGJune 16 - 17, 2011Information and registrationon www.endosono.cz
