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Year : 2021  |  Volume : 10  |  Issue : 5  |  Page : 319-324

Wet- versus dry-suction techniques for EUS-FNA of solid lesions: A systematic review and meta-analysis

1 Department of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, New York, USA
2 Department of Internal Medicine, Mather Hospital, Port Jefferson, New York, USA
3 Langone Health, Inflammatory Bowel Disease Center, New York University, New York, USA; Department of Gastroenterology, School of Medicine, Marmara University, Istanbul, Turkey
4 Division of Gastroenterology, The Brooklyn Hospital Center, Brooklyn, New York, USA
5 Division of Gastroenterology and Hepatology, CHI Health Creighton University Medical Center, Omaha, Nebraska, USA
6 Division of Gastroenterology, Stanford University, Stanford, California, USA
7 Division of Gastroenterology, Rush University Medical Center, Chicago, Illinois, USA
8 Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, USA
9 Division of Gastroenterology, Moffitt Cancer Center, University of South Florida, Tampa, Florida, USA
10 Department of Medical Sciences, Section of Gastroenterology, University of Foggia, 71122 Foggia, Italy
11 Center for Advanced Therapeutic Endoscopy (CATE), Centura Health, Porter Hospital, Peak Gastroenterology, Denver, Colorado, USA

Correspondence Address:
Dr. Douglas G Adler
Porter Adventist Hospital 2525 S Downing St, Denver, CO 80210
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/EUS-D-20-00198

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The optimal sampling techniques for EUS-FNA remain unclear and have not been standardized. To improve diagnostic accuracy, suction techniques for EUS-FNA have been developed and are widely used among endoscopists. The aim of this study was to compare wet-suction and dry-suction EUS-FNA techniques for sampling solid lesions. We performed a comprehensive literature search of major databases (from inception to June 2020) to identify prospective studies comparing wet-suction EUS-FNA and dry-suction EUS-FNA. Specimen adequacy, sample contamination, and histologic accuracy were assessed by pooling data using a random-effects model expressed in terms of odds ratio (OR) and 95% confidence interval (CI). Six studies including a total of 418 patients (365 wet suction vs. 377 dry suction) were included in our final analysis. The study included a total of 535 lesions (332 pancreatic lesions and 203 nonpancreatic lesions). The pooled odds of sample adequacy was 3.18 (CI: 1.82–5.54, P = 0.001) comparing wet- and dry-suction cohorts. The pooled odds of blood contamination was 1.18 (CI: 0.75–1.86, P = 0.1). The pooled rate for blood contamination was 58.33% (CI: 53.65%–62.90%) in the wet-suction cohort and 54.60% (CI 49.90%– 59.24%) in the dry-suction cohort (P = 0.256). The pooled odds of histological diagnosis was 3.68 (CI 0.82–16.42, P = 0.1). Very few adverse events were observed and did not have an impact on patient outcomes using either method. EUS-FNA using the wet-suction technique offers higher specimen quality through comparable rates of blood contamination and histological accuracy compared to dry-suction EUS-FNA.

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