A Pilot Randomized Crossover Trial of Wet Suction and Conventional Techniques of Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Upper Gastrointestinal Subepithelial Lesions.

Mika Takasumi,Rei Suzuki,Jun Nakamura,Ko Watanabe,Hiroki Irie,Yuki Sato,Ryoichiro Kobashi,Yoshinori Okubo,Takuto Hikichi,Masao Kobayakawa,Tsunetaka Kato,Hiromasa Ohira,Hitomi Kikuchi,Minami Hashimoto,Yuichi Waragai,Tadayuki Takagi,Mitsuru Sugimoto,Manabu Hayashi

doi:10.1155/2021/4913107

Abstract

Methods Twenty-six patients with UGI-SELs indicated for EUS-FNA were randomly assigned to the dry-first arm using the dry technique for the first two passes or the wet-first arm using the wet technique for the first two passes using a cross-over design with a ratio of 1 : 1. The primary endpoint was the cellularity score of the EUS-FNA specimens rated on a 4-point scale (0-3). The secondary endpoints were the factors influencing cellularity in each suction technique. Results The mean cellularity score was 1.65 ± 1.20 for the wet technique and 2.00 ± 0.98 for the dry technique (p = 0.068). Logistic regression analysis showed that higher cellularity may be related to the final diagnosis of gastrointestinal stromal tumors in the dry technique and the SEL location in the upper stomach in the wet technique. Conclusion The wet EUS-FNA technique failed to show a potential for improved cellularity of specimens compared to the dry technique for UGI-SELs.

Highlights

Endoscopic ultrasound- (EUS-) guided fine-needle aspiration (EUS-FNA) is a commonly used method to obtain specimens from gastrointestinal (GI) subepithelial lesions (SELs) [1]
The wet suction technique (“wet” technique) has been reported to be a novel way to enhance the quality of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) specimens [7]
A total of 26 patients with UGI-SELs were enrolled in the study

Summary

Introduction

Endoscopic ultrasound- (EUS-) guided fine-needle aspiration (EUS-FNA) is a commonly used method to obtain specimens from gastrointestinal (GI) subepithelial lesions (SELs) [1]. The wet suction technique (“wet” technique) has been reported to be a novel way to enhance the quality of EUS-FNA specimens [7]. No studies have reported on the use of the wet technique for UGI-SELs, for which it can be difficult to obtain specimens compared to lymph node and extraluminal masses. A wet suction technique (“wet” technique) has been developed to improve the quality of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for sampling various solid lesions. No studies have reported on the wet technique for EUS-FNA for gastrointestinal (GI) subepithelial lesions (SELs). The wet EUS-FNA technique failed to show a potential for improved cellularity of specimens compared to the dry technique for UGI-SELs

Methods

Results

Conclusion