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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
| 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)
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Submitter: 河上 洋
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