Your browser doesn't support javascript.
loading
Comparative diagnostic performance of different techniques for EUS-guided fine-needle biopsy sampling of solid pancreatic masses: a network meta-analysis.
Facciorusso, Antonio; Crinò, Stefano Francesco; Ramai, Daryl; Madhu, Deepak; Fugazza, Alessandro; Carrara, Silvia; Spadaccini, Marco; Mangiavillano, Benedetto; Gkolfakis, Paraskevas; Mohan, Babu P; Hassan, Cesare; Repici, Alessandro.
Afiliação
  • Facciorusso A; Gastroenterology Unit, Department of Surgical and Medical Sciences, University of Foggia, Foggia, Italy.
  • Crinò SF; Department of Medicine, Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University Hospital of Verona, Verona, Italy.
  • Ramai D; Department of Gastroenterology and Hepatology, University of Utah Health, Salt Lake City, Utah, USA.
  • Madhu D; Department of Gastroenterology, Lisie Hospital, Kochi, Kerala, India.
  • Fugazza A; Endoscopic Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
  • Carrara S; Endoscopic Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
  • Spadaccini M; Endoscopic Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
  • Mangiavillano B; Gastrointestinal Endoscopy Unit, Humanitas-Mater Domini, Castellanza, Italy.
  • Gkolfakis P; Department of Gastroenterology, "Konstantopouleion-Patision" General Hospital of Nea Ionia, Athens, Greece.
  • Mohan BP; Department of Gastroenterology and Hepatology, University of Utah Health, Salt Lake City, Utah, USA.
  • Hassan C; Endoscopic Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
  • Repici A; Endoscopic Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Gastrointest Endosc ; 97(5): 839-848.e5, 2023 05.
Article em En | MEDLINE | ID: mdl-36657607
BACKGROUND AND AIMS: Evidence is limited on the comparative diagnostic performance of tissue sampling techniques for EUS-guided fine-needle biopsy sampling of pancreatic masses. We performed a systematic review with network meta-analysis to compare these techniques. METHODS: Rates of sample adequacy, blood contamination, and tissue integrity using fine-needle biopsy sampling needles were evaluated. Direct and indirect comparisons were performed among the slow-pull, dry-suction, modified wet-suction, or no-suction techniques. Results are expressed as risk ratio (RR) and 95% confidence interval (CI). RESULTS: Overall, 9 randomized controlled trials (756 patients) were identified. On network meta-analysis, the no-suction technique was significantly inferior to the other techniques (RR, .85 [95% CI, .78-.92] vs slow pull; RR, .85 [95% CI, .78-.92] vs dry suction; RR, .83 [95% CI, .76-.90] vs modified wet suction) in terms of sample adequacy. Consequently, modified wet suction was shown to be the best technique (surface under the cumulative ranking curve score, .90), with the no-suction technique showing poorer performance in terms of sample adequacy (surface under the cumulative ranking curve score, .14). Dry suction was associated with significantly higher rates of blood contamination as compared with the slow-pull technique (RR, 1.44; 95% CI, 1.15-1.80), whereas no suction led to less blood contamination of samples in comparison with other techniques (RR, .71 [95% CI, .52-.97] vs slow pull; RR, .49 [95% CI, .36-.66] vs dry suction; RR, .57 [95% CI, .40-.81] vs modified wet suction). The modified wet-suction technique significantly outperformed dry suction in terms of tissue integrity of the sample (RR, 1.36; 95% CI, 1.06-1.75). CONCLUSIONS: Modified wet suction seemed to provide high rates of integrity and adequate samples, albeit with high blood contamination. The no-suction technique performed significantly worse than other sampling strategies.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Pancreáticas Tipo de estudo: Clinical_trials / Diagnostic_studies / Prognostic_studies / Systematic_reviews Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Pancreáticas Tipo de estudo: Clinical_trials / Diagnostic_studies / Prognostic_studies / Systematic_reviews Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article