{"id":4927,"date":"2021-06-01T09:00:30","date_gmt":"2021-06-01T09:00:30","guid":{"rendered":"https:\/\/endoscopiaterapeutica.net\/pt\/uncategorized\/patologista-em-sala-para-puncao-ecoguiada-vale-a-pena\/"},"modified":"2021-09-21T21:23:50","modified_gmt":"2021-09-21T21:23:50","slug":"patologista-em-sala-para-puncao-ecoguiada-vale-a-pena","status":"publish","type":"post","link":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/patologista-em-sala-para-puncao-ecoguiada-vale-a-pena\/","title":{"rendered":"Patologista em sala para pun\u00e7\u00e3o ecoguiada, vale a pena?"},"content":{"rendered":"

Essa \u00e9 uma pergunta bastante controversa e vem sendo debatida pelos experts h\u00e1 algum tempo, com resultados ainda conflitantes. Afinal, a avalia\u00e7\u00e3o citol\u00f3gica em sala ajuda ou apenas gera mais um \u00f4nus financeiro, visto que a maioria dos conv\u00eanios atualmente n\u00e3o cobre essa pr\u00e1tica no nosso pa\u00eds, sem trazer benef\u00edcios reais ao paciente?<\/span><\/p>\n

O racional do emprego dessa modalidade seria fornecer uma avalia\u00e7\u00e3o em tempo real da adequabilidade do material obtido e, assim, aumentar a acur\u00e1cia diagn\u00f3stica, diminuindo o n\u00famero de pun\u00e7\u00f5es realizadas e, consequentemente, os efeitos adversos do procedimento, al\u00e9m de reduzir o tempo de espera para o diagn\u00f3stico, permitindo in\u00edcio precoce do tratamento definitivo.<\/span><\/p>\n

At\u00e9 alguns anos atr\u00e1s, os ecoendoscopistas eram un\u00e2nimes em advogar o uso rotineiro do patologista em sala, sobretudo para les\u00f5es s\u00f3lidas pancre\u00e1ticas, e se baseavam nos poucos estudos publicados na \u00e9poca, que recomendavam veementemente essa pr\u00e1tica. No entanto, trabalhos mais recentes est\u00e3o demonstrando o oposto, colocando em cheque a perman\u00eancia do patologista em sala. De fato, estudos multic\u00eantricos randomizados controlados n\u00e3o demonstraram haver diferen\u00e7a significativa quanto a acur\u00e1cia do diagn\u00f3stico, qualidade e adequabilidade da amostra, efeitos adversos e tempo de procedimento, apesar do n\u00famero de pun\u00e7\u00f5es ser menor se o patologista estiver presente.<\/span><\/p>\n

Assim, os benef\u00edcios quanto a haver patologista em sala ainda permanecem com opini\u00f5es conflitantes, necessitando de mais investiga\u00e7\u00e3o sobre o tema, e os obst\u00e1culos para expans\u00e3o da pr\u00e1tica incluem desde a escassez de citopatologistas treinados, passando por custo adicional elevado, at\u00e9 maior tempo de procedimento. Como a efici\u00eancia diagn\u00f3stica da pun\u00e7\u00e3o ecoguiada \u00e9 diretamente relacionada \u00e0 experi\u00eancia do m\u00e9dico executante e a t\u00e9cnica utilizada, as vantagens em haver o patologista em sala parecem ser maiores ap\u00f3s exames com pun\u00e7\u00f5es n\u00e3o diagn\u00f3sticas, para os centros com baixa taxa de adequabilidade das amostras e para aqueles em que ecoendoscopistas se encontram em curva de aprendizado.<\/span><\/p>\n

Como quase tudo em endoscopia evolui rapidamente, est\u00e3o desenvolvendo novos meios para aumentar a acur\u00e1cia diagn\u00f3stica das pun\u00e7\u00f5es ecoguiadas. Alguns centros est\u00e3o realizando treinamento dos ecoendoscopistas em citologia com o intuito n\u00e3o de diagn\u00f3stico imediato, mas, sim, de avaliar a adequabilidade do esp\u00e9cime. A telecitopatologia \u00e9 outro m\u00e9todo que vem ganhando destaque. Imagens em tempo real das l\u00e2minas preparadas pelo endoscopista s\u00e3o transmitidas remotamente para avalia\u00e7\u00e3o de um patologista treinado, reduzindo significativamente os custos desse profissional. Foram tamb\u00e9m introduzidos no mercado novos desenhos de agulhas de pun\u00e7\u00e3o e pin\u00e7as de bi\u00f3psias, que preservam a arquitetura tecidual e fornecem material para an\u00e1lise histol\u00f3gica. Por fim, pesquisadores recentemente t\u00eam lan\u00e7ado m\u00e3o da <\/span>intelig\u00eancia artificial<\/span><\/a> para interpretar imagens de l\u00e2minas, com resultados encorajadores, mas ainda distantes da nossa realidade no pa\u00eds.<\/span><\/p>\n

\"\"<\/p>\n

\"\"<\/p>\n

Como citar este artigo<\/h2>\n

Ribeiro MSI. Patologista em sala para pun\u00e7\u00e3o ecoguiada, vale a pena?. Endoscopia Terap\u00eautica; 2021. Dispon\u00edvel em: https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/patologista-em-sala-para-puncao-ecoguiada-vale-a-pena<\/span><\/p>\n

Refer\u00eancias<\/h2>\n
    \n
  1. Keswani RN, Krishnan K,Wani S, et al. Addition of endoscopic ultrasound (EUS)-guided fine needle aspiration and on-site cytology to EUS-guided fine needle biopsy increases procedure time but not diagnostic accuracy. Clin Endosc.2014; 47:242-247<\/span><\/li>\n
  2. Kandel P, Wallace MB. Recent advancement in EUS-guided fine needle sampling. J Gastroenterol. 2019;54:377-387<\/span><\/li>\n
  3. Rapid on-site evaluation (ROSE) with EUS-FNA: The Rose looks beautiful. Yang F et al. Endosc Ultrasound. 2019:283-287<\/span><\/li>\n<\/ol>\n

    Acesse o <\/span>Endoscopia Terap\u00eautica<\/span><\/a> para tomar contato com mais <\/span>artigos comentados<\/span><\/a>, <\/span>assuntos gerais<\/span><\/a>, <\/span>casos cl\u00ednicos<\/span><\/a>, <\/span>quizzes<\/span><\/a>, <\/span>classifica\u00e7\u00f5es<\/span><\/a> e mais!<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

    Essa \u00e9 uma pergunta bastante controversa e vem sendo debatida pelos experts h\u00e1 algum…<\/p>\n","protected":false},"author":3701,"featured_media":7720,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[151],"tags":[],"ano":[262],"tipo":[154],"volume":[263],"class_list":["post-4927","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-assuntosgerais","ano-262","tipo-ecoendoscopia","volume-volume-i"],"yoast_head":"\nPatologista em sala para pun\u00e7\u00e3o ecoguiada, vale a pena? • Endoscopia Terapeutica<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/patologista-em-sala-para-puncao-ecoguiada-vale-a-pena\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Patologista em sala para pun\u00e7\u00e3o ecoguiada, vale a pena?\" \/>\n<meta property=\"og:description\" content=\"Essa \u00e9 uma pergunta bastante controversa e vem sendo debatida pelos experts h\u00e1 algum tempo, com resultados ainda conflitantes. 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