Background: FNA is commonly performed in conjunction with EUS procedures. There is limited prospective
data on complication rates.
Hypothesis: In prospective assessment, FNA is a safe procedure with limited complications in
a high volume EUS referral center.
Methods: Approximately 1200 patients undergo EUS at Mayo Clinic Jacksonville on annual basis
for different indications. Of those, about 40% will undergo FNA. Between April and
October 2005, 230 patients who underwent EUS- FNA were included in this study. These
patients were screened for post-procedural complications including abdominal pain,
nausea, vomiting, fever, gastrointestinal bleeding and dysphagia. Complications were
assessed on day 0 by direct examination and at day 30 by a telephone call... Inquiries
were made about emergency room visits or hospitalizations during the same period of
time.
Results: Table 1 demonstrates location of FNA for all patients (n=230). Complete follow up
information was obtained on 207 patients (90%).
-Day 0: Three patients were admitted to the hospital for observation. Two patients had abdominal
pain after pancreatic cyst FNA and one was observed after mediastinal lymph nodes
FNA for chest pain. All three patients were discharged within 24 hours of admission.
There was no requirement of blood transfusion and no evidence of pancreatitis or infection
in any of the hospitalized patients. One patient reported to the ER after EUS-FNA
and was sent home on oral analgesics after appropriate evaluation.
-Day 30: Four patients expired during the first month after EUS from primary disease process
(3 had pancreatic cancer and one had lung cancer). Five patients were hospitalized
for planned elective surgeries during the same period of time. There was no unplanned
morbidity or mortality attributable to EUS-FNA.
Conclusion: FNA is a safe intervention in patients undergoing EUS in high volume academic center
with post procedural self-limited complication rate of 1%
|
FNA by Location
|
n=230
|
|
Pancreatic masses and cysts
|
103
|
|
Mediastinal masses and lymphadenopathy
|
74
|
|
Abdominal and pelvic lymphadenopathy
|
20
|
|
Gastroduodenal submucosal masses
|
8
|
|
Liver
|
7
|
|
Rectal
|
3
|
|
Miscellaneous
|
15
|
Table 1
