Background and study aims: The study aimed to investigate whether the 25G needle is superior to the 22G needle
when used in endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of solid
lesions.
Patients and methods: The study was a single-center randomized clinical trial. The setting was a tertiary
referral hospital, where EUS-FNA of solid lesions was assisted by an on-site cytopathologist,
who was blinded to the needle size. The main end point was the number of passes performed
to obtain adequate samples. Crossover to the other type of needle was allowed after
five passes, or when the gastroenterologist experienced difficulties in puncturing
the lesions.
Results: A total of 129 solid lesions were randomized and data regarding 127 lesions were
analyzed. The mean number of passes was 3.7 (± 1.9) in the 22G needle group and 3.8
(± 2) in the 25G needle groups (difference of means: 0.1; 95 %CI: – 0.59 to 0.79).
Fifty-eight of 63 (92.1 %) and 60/64 samples (93.7 %) in the 22G and 25G needle groups
respectively were adequate (difference: – 1.6 %; 95 %CI: – 12.1 % to 8.9 %). Crossover
to the other type of needle was performed in 11/63 (17.5 %) and in 12/64 (18.7 %)
lesions in the two groups respectively (difference: – 1.2 %; 95 %CI: – 16.2 % to 13.8 %).
A crossover to the 25G needle was successfully performed in four masses in the uncinate
process; these lesions were difficult to puncture using the 22G needle.
Conclusions: Our study failed to demonstrate that the 25G is more effective than the 22G needle
in EUS-FNA of solid lesions. However, targeting of lesions in the distal duodenum
may be simplified by using the 25G needle.
References
lorenzo.camellini@asmn.re.it
