The Comparison of Wet Suction and Dry Suction Technique in EUS-FNA for the Outcomes in Pancreatic Solid Lesions
Condition: Pancreatic Solid Lesions
Study type: Interventional

Summary: 
      The objective of this randomized controlled trial is to evaluate whether wet suction
      technique (WST), compared with dry suction technique (DST), shall present a better outcome
      with regard to the diagnostic yield and specimen quality of patients with solid lesions in
      the pancreatics.
    

Detailed description: 
      Endoscopic ultrasound guided fine-needle aspiration (EUS-FNA) has become an inevitable
      indispensable method for acquiring a pathological diagnosis in a variety of clinical
      conditions. It has been widely used due to the high sensitivity, specificity and safety. In
      order to improve the puncture efficiency of FNA, many domestic and oversea scholars have
      conducted several clinical trials. Among them, there are many studies on the type of needle,
      needle pattern, slow pull or vacuum suction, and there are only two related reports on wet
      suction (saline) and dry suction technique. There still have many controversies in the
      researchers about which technique is more dominant in the wet or dry suction. The wet suction
      technique is relying on pre-flushing the needle with saline to replace the column of air with
      fluid followed by aspiration at the proximal end, using a prefilled suction syringe with
      saline. It has been suggested that the presence of a saline-solution column might keep the
      needle from getting clogged while avoiding the inherent inconvenience of a metal stylet, so
      that it can improve the quality of specimens, diminish the contamination of blood, and
      increase the diagnostic yield and accuracy. Wet suction may become the development trend of
      EUS-FNA in the future because the application of wet suction is expected to improve the
      diagnostic efficiency and the quality of samples in FNA.
    

Intervention name(s): wet suction technique; dry suction technique
Intervention type(s): Procedure; Procedure
Intervention description(s): For the wet suction technique, after removing the stylet, the needle was flushed with 2 mL of saline solution to replace the column of air with saline solution. A 10-mL suction syringe, loaded to 5ml negative pressure, was attached in a "locked" position to the needle after flushing the needle with saline solution. The needle is moved back and forth 20-30 times by applying negative pressure suction within the lesion. Afterwards, the needle is withdrawn from the lesion.; For the dry suction technique, after locating by EUS, the stylet was removed from the needle before performing FNA. A 10-mL syringe, loaded to 5ml negative pressure, was attached in a "locked" position to the needle. Suction was applied after the lesion was punctured. The needle is moved back and forth 20-30 times by applying negative pressure suction within the lesion. Afterwards, the needle is withdrawn from the lesion.
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Single (Participant)
Primary purpose: Diagnostic
Keywords: Pancreatic solid lesions; wet suction technique; dry suction technique