Endoscopic ultrasound-guided fine-needle marking of lymph nodes.
OBJECTIVE
No previous studies have evaluated the ability of endoscopic ultrasonography to describe the anatomic location of lymph nodes on the basis of a node-to-node comparison. The aim of this study was to assess the feasibility and safety of a new endoscopic ultrasound (EUS)-guided fine-needle technique for marking lymph nodes.


METHODS
Twenty-five patients with suspected or confirmed malignancies of the upper gastrointestinal tract were prospectively included. EUS-guided fine-needle marking (EUS-FNM) was performed with a silver pin with a diameter that allowed it to fit into a 19-gauge needle. The position of the pin was verified by EUS. End points were the ability to identify and isolate the marked lymph node during surgery and a comparison between the location of the pin as suggested by EUS and the actual location found in the resected specimen.


RESULTS
Twenty-three lymph nodes were marked. Nineteen intended surgical isolations were performed. The lymph nodes were isolated in the resection specimens in 18 patients (95 %). In 2 out of 20 cases the pin was not localized by laparoscopic ultrasonography. In 89 % of the cases the marked lymph node was in the same location as described by EUS. One pin (5 %) was not retrieved. In three cases, a small hematoma was observed. There was no sign of long-term complications.


CONCLUSIONS
EUS-FNM with a silver pin in lymph nodes is feasible and safe. EUS-FNM seems to be a suitable tool for evaluating lymph nodes on the basis of a node-to-node comparison.
Larsen
M H
MH
Department of Surgery, Center for Surgical Ultrasound, Odense University Hospital, Odense, Denmark. mhl@dadlnet.dk
Fristrup
C W
CW
Pless
T
T
Ainsworth
A P
AP
Nielsen
H O
HO
Hovendal
C P
CP
Mortensen
M B
MB
D000368:Aged; D044963:Biopsy, Fine-Needle / Q000379:methods*; D003937:Diagnosis, Differential; D019160:Endosonography / Q000379:methods*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis* / Q000556:secondary; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies