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World J Gastroenterol. Oct 28, 2020; 26(40): 6182-6194
Published online Oct 28, 2020. doi: 10.3748/wjg.v26.i40.6182
Overlooked risk for needle tract seeding following endoscopic ultrasound-guided minimally invasive tissue acquisition
Ruo-Yu Gao, Ben-Hua Wu, Xin-Ying Shen, Tie-Li Peng, De-Feng Li, Cheng Wei, Zhi-Chao Yu, Ming-Han Luo, Feng Xiong, Li-Sheng Wang, Jun Yao
Ruo-Yu Gao, Ben-Hua Wu, De-Feng Li, Cheng Wei, Zhi-Chao Yu, Ming-Han Luo, Feng Xiong, Li-Sheng Wang, Jun Yao, Department of Gastroenterology, Second Clinical Medical College of Jinan University, Shenzhen People’s Hospital, Shenzhen 518020, Guangdong Province, China
Xin-Ying Shen, Department of Interventional Medicine, Second Clinical Medical College of Jinan University, Shenzhen People’s Hospital, Shenzhen 518020, Guangdong Province, China
Tie-Li Peng, Department of Gastroenterology, Institute of Digestive Disease of Guangzhou Medical University, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan 511500, Guangdong Province, China
Author contributions: Gao RY prepared the tables and drafted the manuscript; Wu BH, Shen XY, Peng TL, Li DF, Wei C, Yu ZC, Luo MH, and Xiong F reviewed the manuscript for its intellectual content; Wang LS and Yao J were responsible for revising the manuscript; all authors have read and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 81800489.
Conflict-of-interest statement: The authors of this manuscript have no conflicts of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jun Yao, PhD, Doctor, Department of Gastroenterology, Second Clinical Medical College of Jinan University, Shenzhen People’s Hospital, No. 1017 East Gate Road, Shenzhen 518020, Guangdong Province, China. yj_1108@126.com
Received: June 8, 2020
Peer-review started: June 8, 2020
First decision: July 25, 2020
Revised: August 5, 2020
Accepted: September 17, 2020
Article in press: September 17, 2020
Published online: October 28, 2020
Abstract

Endoscopic ultrasound-guided minimally invasive tissue acquisition can be performed by two approaches as follows: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB). These have been evolved into leading approaches and widely used for the histological diagnosis of tumors in the gastrointestinal tract and adjacent organs. However, the role of EUS-FNA and EUS-FNB in disease diagnosis and evaluation remains controversial. Although the incidence of surgery-associated complications remains low, the consequences of needle tract seeding can be serious or even life-threatening. Recently, increasing case reports of needle tract seeding are emerging, especially caused by EUS-FNA. This complication needs serious consideration. In the present work, we integrated these case reports and the related literature, and summarized the relevant cases and technical characteristics of needle tract seeding caused by EUS-FNA and EUS-FNB. Collectively, our findings provided valuable insights into the prevention and reduction of such serious complication.

Keywords: Endoscopic ultrasound-guided fine-needle aspiration, Endoscopic ultrasound-guided fine-needle biopsy, Needle tract seeding, Gastrointestinal tract, Computed tomography

Core Tip: This paper integrates for the first time the case reports and related literature of needle tract seeding caused by endoscopic ultrasound-guided fine-needle aspiration or biopsy, and summarizes in detail the case characteristics of needle tract seeding, including the time interval, tumor location, effective detection methods, the relationship between treatment and prognosis, and the risk factors that may lead to needle tract seeding. Our findings provide valuable insights for preventing and reducing such serious complications.