Endosonographisch gesteuerte Feinnadelpunktion in der pneumologischen Diagnostik

Zusammenfassung

Die durch endoskopischen Ultraschall gesteuerte Feinnadelpunktion hat die Möglichkeiten der pneumologischen Diagnostik wesentlich erweitert. Seit Einführung der Methode wurden an zwei pneumologischen Zentren 1212 Untersuchungen durchgeführt und Daten zu den Indikationen, Untersuchungsabläufen, Ergebnissen, diagnostischen Aussagen und Komplikationen erfasst. Diese Arbeit beschreibt die hieraus abgeleiteten Erfahrungen zu Möglichkeiten und Grenzen der Methode und beurteilt anhand bisheriger Studien den gegenwärtigen Stellenwert der Untersuchungstechnik in der pneumologischen Diagnostik. Sowohl in der Diagnosesicherung unklarer mediastinaler Gewebsveränderungen als auch in der Ausbreitungsdiagnostik maligner Erkrankungen stellt die Methode eine komplikationsarme diagnostische Maßnahme dar, die in vielen Fällen wegweisend für das therapeutische Vorgehen sein kann. In der täglichen Praxis wird die diagnostische Treffsicherheit publizierter Studien allerdings nicht immer erreicht.

Abstract

Endoscopic ultrasound-guided fine-needle aspiration has significantly increased the capacity of pulmonary diagnostic procedures. Since this method was introduced, 1212 examinations have been performed at two centres of pulmonary medicine. Data on indications, procedures, findings, diagnostic yield and complications have been recorded. This paper describes the experiences thus gained regarding the possibilities and limitations of the method and assesses the current significance of the technique in pulmonary medicine according to previous studies. In primary diagnosis of mediastinal tissue alterations and in staging of malignant diseases the method offers a low-complication diagnostic measure which has a seminal impact on therapy in many cases, even though in daily practise the diagnostic accuracy of published studies is not always attained.

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