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REVIEW ARTICLE
Year : 2014  |  Volume : 3  |  Issue : 1  |  Page : 17-21

Basic techniques in endoscopic ultrasound-guided fine-needle aspiration: Role of a stylet and suction


Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Center, Aurora, CO; Division of Gastroenterology and Hepatology, Veterans Affairs Medical Center, Denver, CO, USA

Correspondence Address:
Sachin Wani
Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Center, Aurora, CO; Division of Gastroenterology and Hepatology, Veterans Affairs Medical Center, Denver, CO, USA

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2303-9027.123008

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There are several variables that have been studied to optimize various outcomes of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) such as quality and adequacy of specimens, diagnostic yield of malignancy, accuracy and overall efficiency. Using an evidence-based approach, the objectives of this review are to discuss two key aspects of EUS-FNA: (a) Use of a stylet and (b) use of suction. Level 1 evidence available from randomized controlled trials demonstrates that the use of a stylet during EUS-FNA has no impact on the diagnostic yield of malignancy or the quality of specimens. Air flushing in a slow, controlled fashion is superior to reinsertion of a stylet to express EUS-FNA aspirates. The use of suction should be considered during EUS-FNA of pancreatic masses. However, data from a randomized controlled trial suggest that suction should not be used during EUS-FNA of lymph nodes as it increases bloodiness of specimens obtained and has no impact on the overall diagnostic yield.


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