A prospective randomized study comparing 25-G and 22-G needles of a new platform for endoscopic ultrasound-guided fine needle aspiration of solid masses

Published on Jan 1, 2016in Digestive and Liver Disease4.088
· DOI :10.1016/J.DLD.2015.09.017
Silvia Carrara15
Estimated H-index: 15
,
Andrea Anderloni29
Estimated H-index: 29
+ 7 AuthorsAlessandro Repici75
Estimated H-index: 75
Sources
Abstract
Abstract Background A new needle platform for endoscopic ultrasound-guided fine-needle aspiration biopsy has been developed that allows interchangeability of all needle sizes. Aims To prospectively compare the efficacy of the new 25-G needles and 22-G needles for obtaining an adequate aspirate of solid masses. Methods Randomized controlled trial of 144 patients referred for endoscopic ultrasound-guided fine-needle aspiration of solid pancreatic masses, intraparietal tumours, or lymph-nodes, randomized to the 25-G or 22-G needle arms. Results An adequate specimen was obtained from 74.3% of cases. The sample tended to be more adequate in the 25-G compared to the 22-G group (81% vs. 68%; p = 0.09). Crossover was required in 14 (19%) and 12 (17%) cases in the 22-G and in the 25-G groups, respectively (p = 0.7). The overall rate of adequacy improved from 74% before crossover to 90% after crossover (p  Conclusions The 25-G needle was superior to the 22-G needle for endoscopic ultrasound-guided fine-needle aspiration biopsy. The adequacy and diagnostic accuracy improved after crossover, reaching 90%.
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#2Ahmed ElwassiefH-Index: 3
Last. Anand V. Sahai (UdeM: Université de Montréal)H-Index: 25
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Background and Aim Previous studies comparing endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) results with different gauge needles have all been carried out with the stylet in place and show no clear advantage to the larger 22-G needle. Similar data for stylet-free EUS-FNA (SF-EUS-FNA) are unavailable. The aim of the present study was to determine whether diagnostic yield and specimen adequacy is superior with the 22-G needle as compared to the 25-G needle. Methods All patients ≥18...
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Abstract Background and aims. Few randomized studies have assessed the clinical performance of 25-gauge (25G) needles compared with 22-gauge (22G) needles during endoscopic ultrasound-guided fine needle aspiration (EUS–FNA) biopsy of intra-abdominal lesions. We aimed to compare the diagnostic yield, as well as performance characteristics of 22G versus 25G EUS biopsy needles by determining their diagnostic capabilities, the number of needle passes as well as cellularity of aspirated tissue specim...
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Abstract Objectives. Endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) is widely performed for pancreatic masses. The 25-gauge needle (25G) might be easier to be manipulated and expected to be associated with fewer complications since it is thinner and more flexible than the 22-gauge needle (22G) although obtaining adequate specimens is questioned. In this randomized trial, the authors tried to compare prospectively 25G and 22G in diagnostic accuracy, manipulability from the ope...
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#1Kajsa E. Affolter (UofU: University of Utah)H-Index: 9
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Background Several recent studies have investigated the utility of 19-, 22-, and 25-gauge needles in endoscopic ultrasound-guided fine needle aspiration (EUS–FNA) of pancreatic and peri-pancreatic tumors.
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#1Michael Jonathan Hewitt (West Middlesex University Hospital)H-Index: 2
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Background Preoperative diagnosis of solid pancreatic lesions remains challenging despite advancement in imaging technologies. EUS has the benefit of being a minimally invasive, well-tolerated procedure, although results are operator-dependent. The addition of FNA (EUS-guided FNA) provides samples for cytopathologic analysis, a major advantage over other imaging techniques. Objective To determine the diagnostic accuracy of EUS-FNA for pancreatic cancer. Design This is a meta-analysis of publishe...
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Abstract Background The difference in the diagnostic accuracy of 22- versus 25-gauge needles in EUS-FNA is not clear. Aims To compare the rates of technical success, diagnostic accuracy and complications of EUS-FNA performed with 22-gauge and 25-gauge needles on the same solid pancreatic mass. Methods All patients with solid pancreatic masses evaluated from September 2007 to December 2008 were enrolled and underwent EUS-FNA with both 22- and 25-gauge needles with randomisation of needle sequence...
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#6Eric vanSonnenberg (St. Joseph's Hospital and Medical Center)H-Index: 36
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Background There is a lack of prospective, randomized studies comparing the diagnostic yield and complication rates of 22-gauge and 25-gauge needles during EUS-FNA of solid pancreatic masses. Objectives Our primary aim was to compare the diagnostic yield of 22-gauge and 25-gauge needles. Secondary aims included determining the number of needle passes performed, ease of needle passage, and complications. Design Prospective, randomized study. Setting Tertiary referral centers at Yale University Sc...
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