Randomized controlled trial of comparison of the adequacy, and diagnostic yield of endoscopic ultrasound guided fine needle aspiration with and without a stylet in Indian patients: A prospective single blind study

Abstract

Abstract Background: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is done using EUS-FNA needle with an internal stylet by most of the endosonographers. There is no data to suggest that it improves the quality of cytology specimen, and it is tedious and time-consuming. Aim: To compare EUS-FNA specimens obtained with stylet and without stylet for adequacy of the specimen, amount of blood on the slide, number of passes and diagnostic yield. Materials and Methods: Patients undergoing EUS-FNA of solid lesions by one experienced endosonographer at an Indian tertiary center from October 2013 to July 2014 were included. Totally, 115 consecutive patients with 128 lesions were randomized to undergo EUS-FNA with or without stylet. Cytology slides were evaluated by a single pathologist blinded to FNA technique. Results: EUS-FNA was done with stylet in 66 lesions (Group 1) and without stylet in 62 lesions (Group 2). Site of lesion was lymph node in 67 (52.3%), pancreas in 43 (33.6%), liver in 8 (6.2%), gastrointestinal subepithelial lesion in 4 (3.1%) and others in 6 (4.9%). The average size of the lesion was 23.7 ± 14.8. When outcomes of two groups were compared, there was no statistically significant difference in adequacy of smears (P = 1.00), amount of blood on slides (P = 0.92), number of passes (P = 0.49) and diagnostic yield (P = 0.86). Conclusions: There was no significant difference in adequacy of the specimen, amount of blood on the slide, number of passes and diagnostic yield between with and without a stylet groups. The use of a stylet does not confer any advantage during EUS-FNA.