Reply to M. B. Mortensen

Reply to M. B. Mortensen

I would like to thank Dr. Mortensen on behalf of myself and co-authors for his interest in our recently published prospective study on the safety of EUS-FNA [1]. Dr. Mortensen and his colleagues have previously published their extensive experience in this field [2]. Their study included a total of 3324 patients who underwent EUS, including 670 patients with FNA, and reported an overall complication rate of 0.3 % including two fatalities. I would like to emphasize that the tabulated data presented in our discussion from the eight other EUS safety studies, was meant to be representative rather than inclusive. The inclusion criteria of our and Dr. Mortensen's studies were different and we elected to include, over 12 months, consecutive patients who underwent FNA, regardless of the indication.

The fact that Dr. Mortensen’s data did not reflect any complication difference between EUS alone and EUS-FNA is surprising indeed. We routinely perform follow-up phone calls after all sedated gastrointestinal procedures and we have not detected any increase in complications following EUS alone compared with routine esophagogastroduodenoscopy (unpublished data). I strongly agree with Dr. Mortensen, though, that a potential explanation for the difference in outcome between those two studies resides in the variability of included patient populations and indications. I note that the vast majority of the patients included in our study were outpatients which may reflect a lower degree of underlying co-morbidity.

References

• 1 Al-Haddad M, Wallace M B, Woodward T A. et al . The safety of fine-needle aspiration guided by endoscopic ultrasound: a prospective study.  Endoscopy. 2008;  40 204-208
• 2 Mortensen M B, Fristrup C, Holm F S. et al . Prospective evaluation of patient tolerability, satisfaction with patient information, and complications in endoscopic ultrasonography.  Endoscopy. 2005;  37 146-153