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[Complications of fine needle puncture. DEGUM survey II]
Aim:
In a follow-up survey of the members of the German Society for Ultrasound in Medicine (DEGUM), the use of several fine-needle puncture techniques as well as the frequency and nature of the complications were assessed.
Method:
A questionnaire was sent to all 3364 members of the society.
Results:
95070 fine-needle punctures were reported. Of these, 66379 were done to obtain cytological material (69.8%), 19633 (20.7%) to obtain histological material and 9057 (9.5%) for therapeutic reasons. 38.6% of the punctures were guided by ultrasound (i.e. performed without ultrasonic observation of the puncture process), 35.1% were conducted under ultrasonic view and 26.3% with a special puncture probe. The punctures for cytology were generally done without direct ultrasonic observation (45.6%); the punctures for histology were performed for the most part with puncture probes (56.7%). The therapeutic punctures were monitored with a puncture probe in 52.5%. In 95070 punctures, 765 complications were observed (0.81%), one death (0.0011%) and six metastases in the puncture canal (0.0063%); 0.71% slight and 0.095% severe complications were recorded. The punctures for cytology caused the fewest complications with 0.59%. Those for histology had a complication rate of 0.99% and the therapeutic punctures one of 1.98%. In comparison to our first survey in 1988, complications increased from 0.51% to 0.81% primarily because of increased slight complications, which rose from 0.44% to 0.71%. The severe complications rose from 0.057% to 0.095%. Deaths decreased from 0.0075% to 0.0011%. Metastases in the puncture canal were likewise observed more frequently than in the first survey (0.0063% versus 0.003%). The increase in frequency of complications was predominantly the result of a more careful registration, but also by a wider use of the techniques.
Conclusion:
Ultrasonically guided fine-needle puncture is a method with a low rate of complications, but even this slightly invasive method requires stringent indications.