Stylet slow-pull versus standard suction for endoscopic ultrasound-guided fine-needle aspiration of solid pancreatic lesions: a multicenter randomized trial.
Endoscopy
; 50(5): 497-504, 2018 05.
Article
em En
| MEDLINE
| ID: mdl-29272906
ABSTRACT
BACKGROUND AND STUDY AIM:
Standard endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) procedures involve use of no-suction or suction aspiration techniques. A new aspiration method, the stylet slow-pull technique, involves slow withdrawal of the needle stylet to create minimum negative pressure. The aim of this study was to compare the sensitivity of EUS-FNA using stylet slow-pull or suction techniques for malignant solid pancreatic lesions using a standard 22-gauge needle. PATIENTS ANDMETHODS:
Consecutive patients presenting for EUS-FNA of pancreatic mass lesions were randomized to the stylet slow-pull or suction techniques using a 22-gauge needle. Both techniques were standardized for each pass until an adequate specimen was obtained, as determined by rapid on-site cytology examination. Patients were crossed over to the alternative technique after four nondiagnostic passes.RESULTS:
Of 147 patients screened, 121 (mean age 64â±â13.8 years) met inclusion criteria and were randomized to the stylet slow-pull technique (nâ=â61) or the suction technique (nâ=â60). Technical success rates were 96.7â% and 98.3â% in the slow-pull and suction groups, respectively (Pâ>â0.99). The sensitivity for malignancy of EUS-FNA was 82â% in the slow-pull group and 69â% in the suction group (Pâ=â0.10). The first-pass diagnostic rate (42.6â% vs. 38.3â%; Pâ=â0.71), acquisition of core tissue (60.6â% vs. 46.7â%; Pâ=â0.14), and the median (range) number of passes to diagnosis (2 1 2 3 vs. 1 1 2; Pâ=â0.71) were similar in the slow-pull and suction groups, respectively.CONCLUSIONS:
The stylet slow-pull and suction techniques both offered high and comparable diagnostic sensitivity with a mean of 2 passes required for diagnosis of solid pancreatic lesions. The endosonographer may choose either technique during FNA.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Pancreáticas
/
Adenocarcinoma
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Tumores Neuroendócrinos
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Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
Limite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Endoscopy
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Estados Unidos