title: An automated spring-loaded needle for endoscopic ultrasound-guided abdominal paracentesis in cancer patients.
abstract: OBJECTIVE
  To evaluate the feasibility of using an automated spring-loaded needle device for endoscopic ultrasound (EUS)-guided abdominal paracentesis (EUS-P) to see if this would make it easier to puncture the mobile and lax gastric wall for EUS-P.
  
  
  METHODS
  The EUS database and electronic medical records at Fukushima Medical University Hospital were searched from January 2001 to April 2011. Patients with a history of cancer and who underwent EUS-P using an automated spring-loaded needle device with a 22-gauge puncture needle were included. The needle was passed through the instrument channel and advanced through the gastrointestinal wall under EUS guidance into the echo-free space in the abdominal cavity and ascitic fluid was collected. The confirmed diagnosis of malignant ascites included positive cytology and results from careful clinical observation for at least 6 mo in patients with negative cytology. The technical success rate, cytology results and complications were evaluated.
  
  
  RESULTS
  We found 11 patients who underwent EUS-P with an automated spring-loaded needle device. In 4 cases, ascites was revealed only with EUS but not in other imaging modalities. EUS-P was done in 7 other cases because there was minimal ascitic fluid and no safe window for percutaneous abdominal aspiration. Ascitic fluid was obtained in all cases by EUS-P. The average amount aspirated was 14.1 mL (range 0.5-38 mL) and that was sent for cytological exam. The etiology of ascitic fluid was benign in 5 patients and malignant in 6. In all cases, ascitic fluid was obtained with the first needle pass. No procedure-related adverse effects occurred.
  
  
  CONCLUSIONS
  EUS-P with an automated spring-loaded needle device is a feasible and safe method for ascites evaluation.
authors.affiliation: Rei Suzuki, Tadayuki Takagi, Ai Sato, Masaki Sato, Tsunehiko Ikeda, Ko Watanabe, Jun Nakamura, Hiromasa Ohira, Department of Gastroenterology and Rheumatology, Division of Medicine, Fukushima Medical University School of Medicine, Fukushima 960-1247, Japan.
authors.forename: Rei
authors.initials: R
authors.lastname: Suzuki
authors.affiliation: Rei Suzuki, Tadayuki Takagi, Ai Sato, Masaki Sato, Tsunehiko Ikeda, Ko Watanabe, Jun Nakamura, Hiromasa Ohira, Department of Gastroenterology and Rheumatology, Division of Medicine, Fukushima Medical University School of Medicine, Fukushima 960-1247, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Irisawa
authors.affiliation: Rei Suzuki, Tadayuki Takagi, Ai Sato, Masaki Sato, Tsunehiko Ikeda, Ko Watanabe, Jun Nakamura, Hiromasa Ohira, Department of Gastroenterology and Rheumatology, Division of Medicine, Fukushima Medical University School of Medicine, Fukushima 960-1247, Japan.
authors.forename: Manoop S
authors.initials: MS
authors.lastname: Bhutani
authors.affiliation: Rei Suzuki, Tadayuki Takagi, Ai Sato, Masaki Sato, Tsunehiko Ikeda, Ko Watanabe, Jun Nakamura, Hiromasa Ohira, Department of Gastroenterology and Rheumatology, Division of Medicine, Fukushima Medical University School of Medicine, Fukushima 960-1247, Japan.
authors.forename: Takuto
authors.initials: T
authors.lastname: Hikichi
authors.affiliation: Rei Suzuki, Tadayuki Takagi, Ai Sato, Masaki Sato, Tsunehiko Ikeda, Ko Watanabe, Jun Nakamura, Hiromasa Ohira, Department of Gastroenterology and Rheumatology, Division of Medicine, Fukushima Medical University School of Medicine, Fukushima 960-1247, Japan.
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Takagi
authors.affiliation: Rei Suzuki, Tadayuki Takagi, Ai Sato, Masaki Sato, Tsunehiko Ikeda, Ko Watanabe, Jun Nakamura, Hiromasa Ohira, Department of Gastroenterology and Rheumatology, Division of Medicine, Fukushima Medical University School of Medicine, Fukushima 960-1247, Japan.
authors.forename: Goro
authors.initials: G
authors.lastname: Shibukawa
authors.affiliation: Rei Suzuki, Tadayuki Takagi, Ai Sato, Masaki Sato, Tsunehiko Ikeda, Ko Watanabe, Jun Nakamura, Hiromasa Ohira, Department of Gastroenterology and Rheumatology, Division of Medicine, Fukushima Medical University School of Medicine, Fukushima 960-1247, Japan.
authors.forename: Ai
authors.initials: A
authors.lastname: Sato
authors.affiliation: Rei Suzuki, Tadayuki Takagi, Ai Sato, Masaki Sato, Tsunehiko Ikeda, Ko Watanabe, Jun Nakamura, Hiromasa Ohira, Department of Gastroenterology and Rheumatology, Division of Medicine, Fukushima Medical University School of Medicine, Fukushima 960-1247, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Sato
authors.affiliation: Rei Suzuki, Tadayuki Takagi, Ai Sato, Masaki Sato, Tsunehiko Ikeda, Ko Watanabe, Jun Nakamura, Hiromasa Ohira, Department of Gastroenterology and Rheumatology, Division of Medicine, Fukushima Medical University School of Medicine, Fukushima 960-1247, Japan.
authors.forename: Tsunehiko
authors.initials: T
authors.lastname: Ikeda
authors.affiliation: Rei Suzuki, Tadayuki Takagi, Ai Sato, Masaki Sato, Tsunehiko Ikeda, Ko Watanabe, Jun Nakamura, Hiromasa Ohira, Department of Gastroenterology and Rheumatology, Division of Medicine, Fukushima Medical University School of Medicine, Fukushima 960-1247, Japan.
authors.forename: Ko
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Rei Suzuki, Tadayuki Takagi, Ai Sato, Masaki Sato, Tsunehiko Ikeda, Ko Watanabe, Jun Nakamura, Hiromasa Ohira, Department of Gastroenterology and Rheumatology, Division of Medicine, Fukushima Medical University School of Medicine, Fukushima 960-1247, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Nakamura
authors.affiliation: Rei Suzuki, Tadayuki Takagi, Ai Sato, Masaki Sato, Tsunehiko Ikeda, Ko Watanabe, Jun Nakamura, Hiromasa Ohira, Department of Gastroenterology and Rheumatology, Division of Medicine, Fukushima Medical University School of Medicine, Fukushima 960-1247, Japan.
authors.forename: Srinadh
authors.initials: S
authors.lastname: Annangi
authors.affiliation: Rei Suzuki, Tadayuki Takagi, Ai Sato, Masaki Sato, Tsunehiko Ikeda, Ko Watanabe, Jun Nakamura, Hiromasa Ohira, Department of Gastroenterology and Rheumatology, Division of Medicine, Fukushima Medical University School of Medicine, Fukushima 960-1247, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Tasaki
authors.affiliation: Rei Suzuki, Tadayuki Takagi, Ai Sato, Masaki Sato, Tsunehiko Ikeda, Ko Watanabe, Jun Nakamura, Hiromasa Ohira, Department of Gastroenterology and Rheumatology, Division of Medicine, Fukushima Medical University School of Medicine, Fukushima 960-1247, Japan.
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Obara
authors.affiliation: Rei Suzuki, Tadayuki Takagi, Ai Sato, Masaki Sato, Tsunehiko Ikeda, Ko Watanabe, Jun Nakamura, Hiromasa Ohira, Department of Gastroenterology and Rheumatology, Division of Medicine, Fukushima Medical University School of Medicine, Fukushima 960-1247, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Ohira
keywords: Ascetic fluid; Endoscopic ultrasound; Fine needle aspiration; Malignancy; Paracentesis