Document Detail

EUS-guided FNA of solid pancreatic masses: a prospective, randomized trial comparing 22-gauge and 25-gauge needles.
MedLine Citation:
PMID:  19640524     Owner:  NLM     Status:  MEDLINE    
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 School of Medicine, New Haven, Connecticut, and Virginia Piper Cancer Institute, Minneapolis, Minnesota. PATIENTS: Patients with a suspected solid pancreatic mass from February 2007 to June 2008 were enrolled. INTERVENTIONS: Patients were randomized to EUS-FNA with a 22-gauge or 25-gauge needle. MAIN OUTCOME MEASUREMENTS: A diagnostic result was defined as cytology findings positive for malignant cells. RESULTS: A total of 131 patients were enrolled: EUS-FNA was performed with a 22-gauge needle in 64 patients and with a 25-gauge needle in 67 patients. Cytology was diagnostic in 120 (91.6%) of 131 patients overall: 56 (87.5%) of 64 with 22-gauge needles and 64 (95.5%) of 67 with 25-gauge needles (no statistically significant difference was found between the 2 groups; P=.18). A similar number of passes was performed in both arms (mean [SD] 2.6 [1.2] each; P=.96). There were no complications in either group. LIMITATION: A larger number of patients is needed to determine small differences in diagnostic yield. CONCLUSIONS: This is the first prospective, randomized trial comparing 22-gauge and 25-gauge needles in EUS-FNA of solid pancreatic masses. We achieved equally high diagnostic yields by using a similar number of passes, showing that 25-gauge needles are an effective alternative to 22-gauge needles.
Uzma D Siddiqui; Federico Rossi; Lawrence S Rosenthal; Manmeet S Padda; Visvanathan Murali-Dharan; Harry R Aslanian
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2009-07-28
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  70     ISSN:  1097-6779     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-07     Completed Date:  2010-03-04     Revised Date:  2010-10-06    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1093-7     Citation Subset:  IM    
Yale University School of Medicine, New Haven, Connecticut 06520, USA.
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MeSH Terms
Biopsy, Fine-Needle / adverse effects,  instrumentation*,  methods
Equipment Design
Needles* / adverse effects
Pancreatic Neoplasms / pathology*
Prospective Studies
Comment In:
Gastrointest Endosc. 2009 Dec;70(6):1098-100   [PMID:  19962501 ]
Endoscopy. 2010 Jan;42(1):68-72   [PMID:  20066593 ]
Gastrointest Endosc. 2010 Oct;72(4):904-5; author reply 905   [PMID:  20883873 ]

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