Forward-viewing versus oblique-viewing echoendoscopes in the diagnosis of upper GI subepithelial lesions with EUS-guided FNA: a prospective, randomized, crossover study

被引：31

作者：

Matsuzaki, Ippei ^{[1
]}

Miyahara, Ryoji ^{[1
]}

Hirooka, Yoshiki ^{[2
]}

Funasaka, Kohei ^{[2
]}

Ohno, Eizaburo ^{[1
]}

Nakamura, Masanao ^{[1
]}

Kawashima, Hiroki ^{[1
]}

Nukaga, Akiko ^{[3
]}

Shimoyama, Yoshie ^{[3
]}

Goto, Hidemi ^{[1
,2
]}

机构：

[1] Nagoya Univ, Grad Sch Med, Dept Gastroenterol & Hepatol, Nagoya, Aichi 4668550, Japan

[2] Nagoya Univ Hosp, Dept Endoscopy, Nagoya, Japan

[3] Nagoya Univ Hosp, Dept Pathol & Clin Labs, Nagoya, Aichi, Japan

来源：

GASTROINTESTINAL ENDOSCOPY | 2015年 / 82卷 / 02期

关键词：

FINE-NEEDLE-ASPIRATION; GASTROINTESTINAL STROMAL TUMORS; ENDOSCOPIC SUBMUCOSAL DISSECTION; TRUCUT BIOPSY; TISSUE ACQUISITION; INITIAL EVALUATION; ULTRASOUND; YIELD; RESECTION; STOMACH;

D O I：

10.1016/j.gie.2014.12.051

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background: The role of the forward-viewing echoendoscope compared with the oblique-viewing echoendoscope for EUS-guided FNA (EUS-FNA) of upper GI subepithelial lesions has not been defined. Objective: To compare the diagnostic yield and clinical efficacy of EUS-FNA by using the 2 echoendoscopes in the same upper GI subepithelial lesion. Design: Prospective, randomized, crossover study. Setting: Tertiary-care medical center. Patients: Forty-one patients with an upper GI subepithelial lesion. Interventions: All patients first underwent EUS-FNA with a 19-gauge needle by using both echoendoscopes, based on random selection. When required, 22-gauge or 25-gauge needles were used additionally. Main Outcome Measurements: Comparison of diagnostic yield, tissue sample area, puncture success rates, procedure time, and adverse events. Results: Forty-one patients (median lesion size 22 mm, range 15-63 mm) were enrolled. Rates of histologic diagnosis were 80.5% (33/41) and 73.2% (30/41) (P = .453) by using forward-viewing and oblique-viewing echoendoscopes, respectively. Median tissue sample area in GI stromal tumors (n = 22) obtained with the forward-viewing echoendoscope was larger than with the oblique-viewing echoendoscope (2.46 mm(2) vs 1.00 mm2; P = .046). Puncture success rates were 39 of 41 (95.1%) and 35 of 41 (85.4%; P = .289) with forward-viewing and oblique-viewing echoendoscopes, respectively. Median procedure time was 21 minutes with the forward-viewing echoendoscope and 27 minutes with the oblique-viewing echoendoscope (P = .009). An infectious adverse event occurred in a patient and was treated with antibiotics. Limitations: Small sample size. Conclusion: Diagnostic yield did not differ between the 2 echoendoscopes. However, tissue sample area and procedure time were superior with the forward-viewing echoendoscope.

引用

页码：287 / 295

页数：9

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