Benefit of high negative pressure during endoscopic ultrasound-guided fine-needle aspiration with standard 22-gauge needles for pancreatic lesions: a retrospective comparative study. (2nd January 2019)

• Record Type: Journal Article
• Authors: Sato, Junya; Ishiwatari, Hirotoshi; Sasaki, Keiko; Fujie, Shinya; Kaneko, Junichi; Satoh, Tatsunori; Matsubayashi, Hiroyuki; Kishida, Yoshihiro; Yoshida, Masao; Ito, Sayo; Kawata, Noboru; Imai, Kenichiro; Kakushima, Naomi; Takizawa, Kohei; Hotta, Kinichi; Ono, Hiroyuki
• Is Part Of: Scandinavian journal of gastroenterology. Volume 54:Number 1(2019)
• Page Start: 108
• Page End: 113
• Publication Date: 2019-01-02
• Subjects: EUS-FNA -- pancreatic neoplasm -- suction -- histology -- high negative pressure; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33
• DOI: 10.1080/00365521.2018.1564788
• Languages: English
• ISSNs: 0036-5521

Abstract

Abstract: Objectives: Few studies are available on high negative pressure (HNP) during endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). This study compared the diagnostic yield between HNP and normal negative pressure (NNP) during EUS-FNA for solid pancreatic masses. Methods: Consecutive patients with pancreatic masses who underwent EUS-FNA using a 22-G needle with either HNP or NNP for both the first and second passes were retrospectively examined for diagnostic yield. Rapid on-site evaluation (ROSE) was unavailable at our center. The main outcome measures were the number of passes, diagnostic accuracy and quantity of histological samples. Results: Two hundred patients underwent EUS-FNA ( n = 97, HNP; n = 103, NNP) over a 22-month period. A significantly lower median number of passes was required for HNP than for NNP (2 vs. 3; p < .001). There was no significant difference in diagnostic accuracy between the two groups. The rate of obtaining a histological sample larger than a 10× power field in length was significantly higher for HNP than for NNP (76.4% vs. 59.6%; p = .0019). In the multivariate analysis, a large tumor size (>20 mm) and HNP were identified as factors influencing the acquisition of a larger histological sample. Conclusions: There was no significant difference in diagnostic accuracy between HNP and NNP. HNP required fewer passes without ROSE and was related to the acquisition of a larger histological sample. HNP may be useful when few samples are available for EUS-FNA with NNP or a larger histological sample is needed.