Stylet slow-pull vs. standard suction technique for endoscopic ultrasound-guided fine needle biopsy in pancreatic solid lesions using 20 Gauge Procore™ needle: A multicenter randomized trial

Mitri, Roberto Di; Mocciaro, Filippo; Antonini, Filippo; Scimeca, Daniela; Conte, Elisabetta; Bonaccorso, Ambra; Scibetta, Nunzia; Unti, Elettra; Fornelli, Adele; Giorgini, Sara; Binda, Cecilia; Macarri, Giampiero; Larghi, Alberto; Fabbri, Carlo

doi:10.1016/j.dld.2019.08.023

Cited by 22 publications

(48 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…▶ Table 1 summarizes the characteristics of the seven included studies [10,11,[17][18][19][20][21]. They were all full-text RCTs published between 2017 and 2019; two were initially available only as abstracts from conferences' proceedings at the time of submission that during the revision process became available as full text and whose data were accordingly updated [20,21]. Only two studies [10,20] were multicentric.…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

“…They were all full-text RCTs published between 2017 and 2019; two were initially available only as abstracts from conferences' proceedings at the time of submission that during the revision process became available as full text and whose data were accordingly updated [20,21]. Only two studies [10,20] were multicentric. Two studies were carried out in the US [10,11], 2 in Korea [18,19] and one each in Brazil [21], India [17] and Italy [20].…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

“…Only two studies [10,20] were multicentric. Two studies were carried out in the US [10,11], 2 in Korea [18,19] and one each in Brazil [21], India [17] and Italy [20]. Different needles were employed, with 3 studies employing FNB needles [11,19,20] and 4 FNA [10,17,18,21]).…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

“…Two studies were carried out in the US [10,11], 2 in Korea [18,19] and one each in Brazil [21], India [17] and Italy [20]. Different needles were employed, with 3 studies employing FNB needles [11,19,20] and 4 FNA [10,17,18,21]). Four of the studies randomized distinct individual patients with solid pancreatic lesions to either SU or SP sampling [10,11,17,20], for a total of 327 patients (164 SP, 163 SU); the remaining 3 studies [18,19,21] randomized the same patients with solid pancreatic lesions to both SU and SP sampling in a random order, for a total of 148 patients.…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

“…Five of the seven examined studies [17,21] reported data on the degree of blood contamination. We calculated the rate of highest degree of blood contamination as defined in the 5 studies as "blood clots present" [17], "blood in > 50 % of the slide" [19], "interference with the making of pathological diagnosis due to large amount of blood cells" [18], significant blood contamination [20] and red blood cells > 50 % [21]. The pooled rate of high blood contamination resulted higher with SU, being of 19.7 % (95 % CI 6.8 %-45.4 %; I 2 = 92.6 %) with SP and 27.6 % (95 % CI 13.2 %-48.8 %; I 2 = 90 %) with SU (Supplementary Fig.…”

Section: High Degree Of Blood Contaminationmentioning

confidence: 99%

See 4 more Smart Citations

Slow-pull compared to suction technique for EUS-guided sampling of pancreatic solid lesions: a meta-analysis of randomized controlled trials

2020

View full text Add to dashboard Cite

Background and study aims Current ESGE guidelines suggest employing the suction (SU) technique for endoscopic ultrasound (EUS)-guided sampling of pancreatic solid lesions. Nonetheless, recent randomized controlled trials (RCT) have reported that the slow-pull (SP) technique has similar diagnostic accuracy with possibly less blood contamination. However, these results are heterogeneous and limited to small cohorts. The aim of this meta-analysis was to compare adequacy, accuracy, sensitivity and specificity of the SU and SP techniques for EUS-guided sampling of solid pancreatic lesions. Methods A computerized bibliographic search was restricted to RCTs. Pooled effects were calculated using a random-effects model and expressed in terms of pooled sensitivity and specificity and OR (95 % CI) for adequacy and accuracy. Results Overall, seven RCTs were included, for a total of 475 patients (163 lesions sampled with SU, 164 with SP and 148 by both). The adequacy was similar (OR = 0.98) without heterogeneity (I2 = 0 %), but a high degree of blood contamination was more common with SU than SP (pooled rate 27.6 % vs 19.7 %). A non-significant superiority of SP in terms of pooled accuracy (OR = 0.82; 95 % CI 0.36–1.85) was recorded, with moderate heterogeneity (I2 = 52.4 %). The SP technique showed a slightly higher pooled sensitivity compared to SU (88.7 % vs 83.4 %), while specificity was similar (97.2 % SP vs 96.9 % SU), with considerable heterogeneity. Conclusion The current meta-analysis reveals non-superiority of SU over SP, while SP results in reduced blood contamination. If the 5 % accuracy difference favouring SP is true, with alfa error = 0.05 and beta = 0.20, a RCT of 982 patients per arm is needed to confirm significance.

show abstract

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

Section: High Degree Of Blood Contaminationmentioning

confidence: 99%

See 3 more Smart Citations

Slow-pull compared to suction technique for EUS-guided sampling of pancreatic solid lesions: a meta-analysis of randomized controlled trials

2020

View full text Add to dashboard Cite

show abstract

Comparison of the slow‐pull and aspiration methods of endobronchial ultrasound‐guided transbronchial needle aspiration for next‐generation sequencing‐compatible tissue collection in non‐small cell lung cancer

Kajita,

Teranishi,

Sawazumi

et al. 2023

Cancer Medicine

View full text Add to dashboard Cite

BackgroundPersonalized treatment for non‐small cell lung cancer (NSCLC) has advanced rapidly, and elucidating the genetic changes that trigger this disease is crucial for appropriate treatment selection. Both slow‐pull and aspiration methods of endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) are accepted methods for collecting samples suitable for next‐generation sequencing (NGS) to examine driver gene mutations and translocations in NSCLC. Here, we aimed to determine which of these two methods is superior for obtaining higher‐quality samples from patients with NSCLC.MethodsSeventy‐one patients diagnosed with NSCLC via EBUS‐TBNA using the slow‐pull or aspiration (20‐mL negative pressure) methods between July 2019 and September 2022 were included. A total of 203 tissue samples from the 71 patients were fixed in formalin, embedded in paraffin, and mounted on slides. The presence of tissue cores, degree of blood contamination, and number of tumor cells were compared between the groups. The success rate of NGS, using Oncomine Dx Target Test Multi‐CDx, was also compared between the groups.ResultsThe slow‐pull method was associated with a higher yield of tissue cores, lower degree of blood contamination, and higher number of tumor cells than the aspiration method. The success rate of the NGS was also significantly higher for the slow‐pull group (95%) than for the aspiration group (68%).ConclusionOverall, these findings suggest that the slow‐pull method is a superior technique for EBUS‐TBNA to obtain high‐quality tissue samples for NGS. The slow‐pull method may contribute to the identification of driver gene mutations and translocations and facilitate personalized treatment of NSCLC.

show abstract

Comparison of Fork‐tip and Franseen needles for endoscopic ultrasound‐guided fine‐needle biopsy in pancreatic solid lesions: A propensity‐matched analysis

et al. 2022

View full text Add to dashboard Cite

Objectives There is no unanimity regarding the most appropriate needle to use for an endoscopic ultrasound‐guided fine‐needle biopsy (EUS‐FNB). To date, new types of FNB needles have been designed, including the Fork‐tip and Franseen needles. This study primarily aimed to compare the diagnostic accuracy and histological quality between the use of the Franseen and Fork‐tip needles in EUS‐FNB for solid pancreatic lesions. Materials and methods We retrospectively analyzed 147 patients at our center for solid pancreatic lesions, 75 of whom underwent EUS‐FNB using a 22‐G Franseen needle, and 72 using a 22‐G Fork‐tip needle, from December 2019 to September 2021. The present study conducted a propensity‐matched analysis and confounder adjustment. Results The diagnostic accuracy of the Fork‐tip group (93.3%, 42/45) was the same as that of the Franseen group. For the core tissue and blood scores, no significant difference was observed ( p = 0.58, 0.25) between the two groups. The rate of changes in the operator from that of a trainee to an expert was less in the Fork‐tip group (4.4%, 2/45) than in the Franseen group (15.6%, 7/45), but not significantly different ( p = 0.16). Conclusions In both groups, the diagnostic accuracy and histological quality were not significantly different. Additionally, there were no significant differences in the rate of operator changes. As both needles are useful, the choice of using either of them is equally good.

show abstract

Stylet slow-pull vs. standard suction technique for endoscopic ultrasound-guided fine needle biopsy in pancreatic solid lesions using 20 Gauge Procore™ needle: A multicenter randomized trial

Cited by 22 publications

References 21 publications

Slow-pull compared to suction technique for EUS-guided sampling of pancreatic solid lesions: a meta-analysis of randomized controlled trials

Slow-pull compared to suction technique for EUS-guided sampling of pancreatic solid lesions: a meta-analysis of randomized controlled trials

Comparison of the slow‐pull and aspiration methods of endobronchial ultrasound‐guided transbronchial needle aspiration for next‐generation sequencing‐compatible tissue collection in non‐small cell lung cancer

Comparison of Fork‐tip and Franseen needles for endoscopic ultrasound‐guided fine‐needle biopsy in pancreatic solid lesions: A propensity‐matched analysis

Contact Info

Product

Resources

About