EUS-guided fine needle tattooing (EUS-FNT) for preoperative localization of small pancreatic neuroendocrine tumors (p-NETs): a single-center experience.
Adult
Aged
Endoscopic Ultrasound-Guided Fine Needle Aspiration
/ methods
Female
Humans
Injections, Intralesional
Insulinoma
/ diagnostic imaging
Laparoscopy
Male
Middle Aged
Neuroendocrine Tumors
/ diagnostic imaging
Pancreatic Neoplasms
/ diagnostic imaging
Preoperative Care
Retrospective Studies
Tattooing
/ methods
Time Factors
EUS
Endoscopic ultrasound
Pancreatic neuroendocrine tumors
Tattoo
pNET
Journal
Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
05
05
2020
accepted:
14
09
2020
pubmed:
23
9
2020
medline:
22
6
2021
entrez:
22
9
2020
Statut:
ppublish
Résumé
and study aims Pancreatic neuroendocrine tumors (pNETs) can be difficult to detect intra-operatively. The aim of this paper is to evaluate the safety and efficacy of preoperative endoscopic ultrasound guided fine needle tattooing (EUS-FNT) to facilitate intra-operative detection of pNETs. Sixteen patients with pNETs (8 insulinoma and 8 non-functional pancreatic neuroendocrine tumors) underwent EUS-FNT. The procedure was carried out using the conventional curvilinear EUS. Tattooing was performed by intralesional injection of 1-2 mL of Spot® ink (Spot®, GI Supply, Comp Hill, PA, US) using a standard 22 gauge EUS-FNA needle. All identified pNETs could be tattooed in one session. The procedure was well tolerated in all patients without any complication. The time interval between tattooing and surgery was between 1 and 565 days (mean of 52 days). Nine patients underwent open and seven laparoscopic surgery. The tattooed lesions could be recognized in all but one patient. In one patient, a small hematoma secondary to the EUS-FNT was observed. Pathological examination of the resection specimen showed local R0 resection in all cases, and no interference with the specimen evaluation was encountered. Our results suggest that EUS-guided FNT is a safe and useful method to mark preoperatively small (≤ 2 cm) pNETs.
Sections du résumé
BACKGROUND
and study aims Pancreatic neuroendocrine tumors (pNETs) can be difficult to detect intra-operatively. The aim of this paper is to evaluate the safety and efficacy of preoperative endoscopic ultrasound guided fine needle tattooing (EUS-FNT) to facilitate intra-operative detection of pNETs.
PATIENTS AND METHODS
Sixteen patients with pNETs (8 insulinoma and 8 non-functional pancreatic neuroendocrine tumors) underwent EUS-FNT. The procedure was carried out using the conventional curvilinear EUS. Tattooing was performed by intralesional injection of 1-2 mL of Spot® ink (Spot®, GI Supply, Comp Hill, PA, US) using a standard 22 gauge EUS-FNA needle.
RESULTS
All identified pNETs could be tattooed in one session. The procedure was well tolerated in all patients without any complication. The time interval between tattooing and surgery was between 1 and 565 days (mean of 52 days). Nine patients underwent open and seven laparoscopic surgery. The tattooed lesions could be recognized in all but one patient. In one patient, a small hematoma secondary to the EUS-FNT was observed. Pathological examination of the resection specimen showed local R0 resection in all cases, and no interference with the specimen evaluation was encountered.
CONCLUSIONS
Our results suggest that EUS-guided FNT is a safe and useful method to mark preoperatively small (≤ 2 cm) pNETs.
Identifiants
pubmed: 32959183
doi: 10.1007/s00464-020-07996-5
pii: 10.1007/s00464-020-07996-5
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
486-492Références
O'Grady HL, Conlon KC (2008) Pancreatic neuroendocrine tumours. Eur J Surg Oncol 34:324–332
doi: 10.1016/j.ejso.2007.07.209
Farrell JJ, Sherrod A, Parekh D (2009) EUS-guided fine-needle tattooing for preoperative localization of early pancreatic adenocarcinoma. Gastrointest Endosc 69:176–177
doi: 10.1016/j.gie.2008.03.1069
Gagner M, Pomp A, Herrera MF (1996) Early experience with laparoscopic resections of islet cell tumors. Surgery 120:1051–1054
doi: 10.1016/S0039-6060(96)80054-7
Briggs CD, Mann CD, Irving GR, Neal CP, Peterson M, Cameron IC, Berry DP (2009) Systematic review of minimally invasive pancreatic resection. J Gastrointest Surg 13:1129–1137
doi: 10.1007/s11605-008-0797-z
Hu M, Zhao G, Luo Y, Liu R (2011) Laparoscopic versus open treatment for benign pancreatic insulinomas: an analysis of 89 cases. Surg Endosc 25:3831–3837
doi: 10.1007/s00464-011-1800-4
Jaroszewski DE, Schlinkert RT, Thompson GB, Schlinkert DK (2004) Laparoscopic localization and resection of insulinomas. Arch Surg 139:270–274
doi: 10.1001/archsurg.139.3.270
Ayav A, Bresler L, Brunaud L et al (2005) Laparoscopic approach for solitary insulinoma: a multicentre study. Langenbecks Arch Surg 390:134–140
doi: 10.1007/s00423-004-0526-3
Fasanella KE, McGrath KM, Sanders M, Brody D, Domsic R, Khalid A (2009) Pancreatic endocrine tumor EUS-guided FNA DNA microsatellite loss and mortality. Gastrointest Endosc 69:1074–1080
doi: 10.1016/j.gie.2008.06.023
Anderson MA, Carpenter S, Thompson NW, Nostrant TT, Elta GH, Scheiman JM (2000) Endoscopic ultrasound is highly accurate and directs management in patients with neuroendocrine tumors of the pancreas. Am J Gastroenterol 95:2271–2277
doi: 10.1111/j.1572-0241.2000.02480.x
Leeds JS, Nayar MK, Bekkali NLH, Wilson CH, Johnson SJ, Haugk B, Darne A, Oppong KW (2019) Endoscopic ultrasound-guided fine-needle biopsy is superior to fine-needle aspiration in assessing pancreatic neuroendocrine tumors. Endosc Int Open 7:E1281–E1287
doi: 10.1055/a-0990-9611
Eusebi LH, Thorburn D, Toumpanakis C, Frazzoni L, Johnson G, Vessal S, Luong TV, Caplin M, Pereira SP (2019) Endoscopic ultrasound-guided fine-needle aspiration vs fine-needle biopsy for the diagnosis of pancreatic neuroendocrine tumors. Endosc Int Open 7:E1393–E1399
doi: 10.1055/a-0967-4684
Larghi A, Capurso G, Carnuccio A, Ricci R, Alfieri S, Galasso D, Lugli F, Bianchi A, Panzuto F, De Marinis L, Falconi M, Delle Fave G, Doglietto GB, Costamagna G, Rindi G (2012) Ki-67 grading of nonfunctioning pancreatic neuroendocrine tumors on histologic samples obtained by EUS-guided fine-needle tissue acquisition: a prospective study. Gastrointest Endosc 76:570–577
doi: 10.1016/j.gie.2012.04.477
Gleeson FC, Levy MJ (2011) Endoscopic ultrasound. Endoscopy 43:54–57
doi: 10.1055/s-0030-1256066
Ashida R, Yamao K, Okubo K, Sawaki A, Mizuno N, Nakamura T, Tajika M, Kawai H, Shimizu Y (2006) Indocyanine green is an ideal dye for endoscopic ultrasound-guided fine-needle tattooing of pancreatic tumors. Endoscopy 38:190–192
doi: 10.1055/s-2005-870404
Larsen MH, Fristrup CW, Mortensen MB (2009) Endoscopic ultrasound-guided fine-needle marking of a small pancreatic tumor. Endoscopy 41(Suppl 2):E175–E176
doi: 10.1055/s-0029-1214699
Falconi M, Eriksson B, Kaltsas G, Bartsch DK, Capdevila J, Caplin M, Kos-Kudla B, Kwekkeboom D, Rindi G, Klöppel G, Reed N, Kianmanesh R, Jensen RT, VC Conference participants (2016) ENETS consensus guidelines update for the management of patients with functional pancreatic neuroendocrine tumors and non-functional pancreatic neuroendocrine tumors. Neuroendocrinology 103:153–171
doi: 10.1159/000443171
Rimbaş M, Horumbă M, Rizzatti G, Crinò SF, Gasbarrini A, Costamagna G, Larghi A (2020) Interventional endoscopic ultrasound for pancreatic neuroendocrine neoplasms. Dig Endosc. https://doi.org/10.1111/den.13635
doi: 10.1111/den.13635
pubmed: 31995848
Rösch T, Lightdale CJ, Botet JF, Boyce GA, Sivak MV Jr, Yasuda K, Heyder N, Palazzo L, Dancygier H, Schusdziarra V, Classen M (1992) Localization of pancreatic endocrine tumors by endoscopic ultrasonography. N Engl J Med 326:1721–1726
doi: 10.1056/NEJM199206253262601
Kann PH (2018) Is endoscopic ultrasonography more sensitive than magnetic resonance imaging in detecting and localizing pancreatic neuroendocrine tumors? Rev Endocr Metab Disord 19:133–137
doi: 10.1007/s11154-018-9464-1
Sallinen VJ, Le Large TYS, Tieftrunk E, Galeev S, Kovalenko Z, Haugvik SP, Antila A, Franklin O, Martinez-Moneo E, Robinson SM, Panzuto F, Regenet N, Muffatti F, Partelli S, Wiese D, Ruszniewski P, Dousset B, Edwin B, Bartsch DK, Sauvanet A, Falconi M, Ceyhan GO, Gaujoux S, Pancreas (2000) research group (2008) Prognosis of sporadic resected small (≤2 cm) nonfunctional pancreatic neuroendocrine tumors—a multi-institutional study. HPB 20:251–259
doi: 10.1016/j.hpb.2017.08.034
Gress FG, Barawi M, Kim D, Grendell JH (2002) Preoperative localization of a neuroendocrine tumor of the pancreas with EUS-guided fine needle tattooing. Gastrointest Endosc 55:594–597
doi: 10.1067/mge.2002.122580
Zografos GN, Stathopoulou A, Mitropapas G, Karoubalis J, Kontogeorgos G, Kaltsas G, Piaditis G, Papastratis GI (2005) Preoperative imaging and localization of small sized insulinoma with EUS-guided fine needle tattoing: a case report. Hormones 4:111–116
pubmed: 16613814
Rodriguez A, Canto MI, Makary MA (2011) Endoscopic localization and tattooing of a proinsulinoma for minimally invasive resection. Pancreas 40:474–477
doi: 10.1097/MPA.0b013e318205e926
Leelasinjaroen P, Manatsathit W, Berri R, Barawi M, Gress FG (2014) Role of preoperative endoscopic ultrasound-guided fine-needle tattooing of a pancreatic head insulinoma. World J Gastrointest Endosc 6:506–509
doi: 10.4253/wjge.v6.i10.506
Okuzono T, Kanno Y, Nakahori M, Aoki H, Sato S, Matsuda T, Chonan A (2016) Preoperative endoscopic ultrasonography-guided tattooing of the pancreas with a minuscule amount of marking solution using a newly designed injector. Dig Endosc 28:744–748
doi: 10.1111/den.12675
Jani N, Khalid A, Kaushik N, Brody D, Bauer K, Schoedel K, Ohori NP, Moser AJ, Lee K, McGrath K (2008) EUS-guided FNA diagnosis of pancreatic endocrine tumors: new trends identified. Gastrointest Endosc 67:44–50
doi: 10.1016/j.gie.2007.07.046
Newman NA, Lennon AM, Edil BH, Gilson MM, Giday SA, Canto MI, Schulick RD, Makary MA (2010) Preoperative endoscopic tattooing of pancreatic body and tail lesions decreases operative time for laparoscopic distal pancreatectomy. Surgery 148:371–377
doi: 10.1016/j.surg.2010.04.008
Sato N, Takano S, Yoshitomi H, Furukawa K, Takayashiki T, Kuboki S, Suzuki D, Sakai N, Kagawa S, Mishima T, Nakadai E, Mikata R, Kato N, Ohtsuka M (2020) Needle tract seeding recurrence of pancreatic cancer in the gastric wall with paragastric lymph node metastasis after endoscopic ultrasound-guided fine needle aspiration followed by pancreatectomy: a case report and literature review. BMC Gastroenterol. https://doi.org/10.1186/s12876-020-1159-x
doi: 10.1186/s12876-020-1159-x
pubmed: 32831030
pmcid: 7446213