Fine needle aspiration of hepatic colorectal metastases: Authors' reply

doi:10.1136/bmj.329.7460.290-c

BMJ 2004;329:290-291 (31 July), doi:10.1136/bmj.329.7460.290-c

Letter

Fine needle aspiration of hepatic colorectal metastases

Authors' reply

The first 150 words of the full text of this article appear below.

EDITOR—We are delighted to have provoked such a livelydebate with our article. The only weakness anticipated in advanceof publication was that it perhaps represented rather "old news."It is gratifying then to find that its message merited vigorousreiteration.

In response to the specific points of Sanz and del Valle, laparoscopicbiopsy is minimally invasive and reduces the risks of both sampleerror and tract metastases. Positron emission spectroscopy isof similar sensitivity to fine needle aspiration cytology, weagree, and not attended by the risk of seeding metastases.

Joseph describes reducing the risk of tract metastases by modificationsof technique, although no evidence is presented for this. Thisimplies an acknowledgment of the risk itself. He seems to bearguing for risk reduction rather than elimination. We disagree.However, Joseph is quite correct to acknowledge that he maybe unaware of the rate of this . . . [Full text of this article]

M S Metcalfe, visiting surgeon, F H G Bridgewater, consultant surgeon, E J Mullin, research registrar, G J Maddern, professor of surgery

Lisa.Leopardi@nwahs.sa.go, University of Adelaide Department of Surgery, Queen Elizabeth Hospital, Woodville, SA 5011, Australia