Eliminating the Residual Negative Pressure in the Endoscopic Ultrasound Aspirating Needle Enhances Cytology Yield of Pancreas Masses

Digestive Diseases and Sciences
A Aziz AadamKulwinder S Dua

Abstract

Prior to withdrawing the EUS-FNA needle from the lesion, the stopcock of the suction syringe is closed to reduce contamination. Residual negative pressure (RNP) may persist in the needle despite closing the stopcock. To determine whether neutralizing RNP before withdrawing the needle will improve the cytology yield. Bench-top testing was done to confirm the presence of RNP followed by a prospective, randomized, cross-over study on patients with pancreas mass. Ten milliliters of suction was applied to the FNA needle. Before withdrawing the needle from the lesion, the stopcock was closed. Based on randomization, the first pass was done with the stopcock either attached to the needle (S+) or disconnected (S-) to allow air to enter and neutralize RNP and accordingly the second pass was crossed over to S+ or S-. On-site cytopathologist was blinded to S+/S-. Bench tests confirmed the presence of RNP which was successfully neutralized by disconnecting the syringe (S-) from the needle. Sixty patients were enrolled, 120 samples analyzed. S+ samples showed significantly greater GI tract contamination compared to S- samples (16.7 vs. 6.7%, p = 0.03). Of the 53 patients confirmed to have pancreas adenocarcinoma, FNA using S- approach was p...Continue Reading

Associated Clinical Trials

Apr 14, 2021·Dr. med. Hector Eloy Tamez Perez

References

Jun 24, 2003·The American Journal of Gastroenterology·Jason B KlapmanIrving Waxman
Jan 15, 2004·Gastrointestinal Endoscopy·Howard Mertz, Shiva Gautam
Feb 21, 2009·Gastrointestinal Endoscopy·Thomas J Savides
Jul 16, 2010·Scandinavian Journal of Gastroenterology·Martin KlimentFrantisek Jaluvka
Apr 26, 2011·Gastrointestinal Endoscopy·Amit RastogiMojtaba Olyaee
Jan 18, 2012·Gastrointestinal Endoscopy·Michael Jonathan HewittKevin J Monahan
Feb 2, 2013·Gastrointestinal Endoscopy·Ji Young BangShyam Varadarajulu
Nov 13, 2013·Gastrointestinal Endoscopy Clinics of North America·Larissa L Fujii, Michael J Levy
Jan 17, 2014·Digestive Diseases and Sciences·Yousuke NakaiKazuhiko Koike
Dec 2, 2014·Gastrointestinal Endoscopy·Sachin WaniSrinadh Komanduri

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Citations

Jul 14, 2020·Endoscopic Ultrasound·Bojan Kovacevic, Peter Vilmann
Mar 13, 2020·Minerva gastroenterologica e dietologica·Antonio Facciorusso

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