LUMINAL PLENARY: OR-LUM-02: Endoscopic ultrasound-guided fine needle aspiration for liver lesions: Comparative results in a large series of more than 150 patients with primary and secondary tumors

Background: Different types of endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) techniques are used in clinical practice; the best method in terms of outcome is not standardized. Objectives: To compare diagnostic adequacy of aspirated material, cytopathologic and EUS morphological features among capillary action, suction, and no suction FNA methods. Methods: A prospective, singleblinded, randomized study was conducted at a tertiary care hospital. A total of 37 patients were excluded, and a total of 300 (100 in each arm) patients were included. Patients were randomized into the three groups, i.e., capillary action (Group 1), suction (Group 2), and no suction (Group 3). Results: A total of 300 patients (195 males) underwent EUS-guided FNA of 235 lymph nodes and 65 pancreatic masses (distribution not statistically different among groups); mean age was 52 ± 14 years. A 22-gauze needle (93%) was used in majority. There was no statistically difference among all the groups regarding lymph node size at large axis and ratio, type of needle, echo-features, echogenicity, calcification, necrosis, shape, borders (lymph nodes), number of passes, and cellularity. Diagnostic adequacy of the specimen was 91%, 91%, and 94% in Groups 1, 2, and 3, respectively (P = 0.665). The suction group had significantly more number of slides and more hemorrhagic slides in comparison to other groups. Conclusion: EUS-guided FNA by capillary action, suction, and no suction methods has similar diagnostic adequacy of specimen; suction method has disadvantage of more number of slides and more hemorrhagic slides.