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

Ippei Matsuzaki, Ryoji Miyahara, Yoshiki Hirooka, Kohei Funasaka, Eizaburo Ohno, Masanao Nakamura, Hiroki Kawashima, Akiko Nukaga, Yoshie Shimoyama, Hidemi Goto

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)

Abstract

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 mm2 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.

Original languageEnglish
Pages (from-to)287-295
Number of pages9
JournalGastrointestinal endoscopy
Volume82
Issue number2
DOIs
Publication statusPublished - 01-08-2015
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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