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High and low negative pressure suction techniques in EUS- guided fine- needle tissue acquisition by using 25-gauge needles: a multicenter, prospective, randomized, controlled trial

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Title: High and low negative pressure suction techniques in EUS- guided fine- needle tissue acquisition by using 25-gauge needles: a multicenter, prospective, randomized, controlled trial
Authors: Kudo, Taiki Browse this author
Kawakami, Hiroshi Browse this author →KAKEN DB
Hayashi, Tsuyoshi Browse this author →KAKEN DB
Yasuda, Ichiro Browse this author
Mukai, Tsuyoshi Browse this author
Inoue, Hiroyuki Browse this author
Katanuma, Akio Browse this author
Kawakubo, Kazumichi Browse this author
Ishiwatari, Hirotoshi Browse this author →KAKEN DB
Doi, Shinpei Browse this author
Yamada, Reiko Browse this author
Maguchi, Hiroyuki Browse this author
Isayama, Hiroyuki Browse this author →KAKEN DB
Mitsuhashi, Tomoko Browse this author →KAKEN DB
Sakamoto, Naoya Browse this author →KAKEN DB
Issue Date: Dec-2014
Publisher: Elsevier
Journal Title: Gastrointestinal endoscopy
Volume: 80
Issue: 6
Start Page: 1030
End Page: 1037
Publisher DOI: 10.1016/j.gie.2014.04.012
PMID: 24890422
Abstract: Background: EUS-guided FNA (EUS-FNA) has a high diagnostic accuracy for pancreatic diseases. However, although most reports have typically focused on cytology, histological tissue quality has rarely been investigated. The effectiveness of EUS-FNA combined with high negative pressure (HNP) suction was recently indicated for tissue acquisition, but has not thus far been tested in a prospective, randomized clinical trial. Objective: To evaluate the adequacy of EUS-FNA with HNP for the histological diagnosis of pancreatic lesions by using 25-gauge needles. Design: Prospective, single-blind, randomized, controlled crossover trial. Setting: Seven tertiary referral centers. Patients: Patients referred for EUS-FNA of pancreatic solid lesions. From July 2011 to April 2012, 90 patients underwent EUS-FNA of pancreatic solid masses by using normal negative pressure (NNP) and HNP with 2 respective passes. The order of the passes was randomized, and the sample adequacy, quality, and histology were evaluated by a single expert pathologist. Intervention: EUS-FNA by using NNP and HNP. Main Outcome Measurements: The adequacy of tissue acquisition and the accuracy of histological diagnoses made by using the EUS-FNA technique with HNP. Results: We found that 72.2% (65/90) and 90% (81/90) of the specimens obtained using NNP and HNP, respectively, were adequate for histological diagnosis (P = .0003, McNemar test). For 73.3% (66/90) and 82.2% (74/90) of the specimens obtained by using NNP and HNP, respectively, an accurate diagnosis was achieved (P = .06, McNemar test). Pancreatitis developed in 1 patient after this procedure, which subsided with conservative therapy. Limitations: This was a single-blinded, crossover study. Conclusion: Biopsy procedures that combine the EUS-FNA with HNP techniques are superior to EUS-FNA with NNP procedures for tissue acquisition.
Type: article (author version)
URI: http://hdl.handle.net/2115/57915
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 河上 洋

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