The Comparison of Wet Suction and Dry Suction Technique in EUS-FNA for the Outcomes in Pancreatic Solid Lesions

Pancreatic Solid Lesions Clinical Trial

Official title:

The Comparison of Wet Suction Technique and Dry Suction Technique in Endoscopic Ultrasound-guided Fine-needle Aspiration (EUS-FNA) for the Outcomes in Pancreatic Solid Lesions: a Prospective, Randomized Controlled, Blinded Trial

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03821974
• Other study ID #: EUS2019-001
• Status: Completed
• Phase: N/A
• Start date: January 3, 2019
• Est. completion date: March 31, 2020

Study information

• Verified date: June 2021
• Source: The Third Xiangya Hospital of Central South University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial 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.

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 50
• Est. completion date: March 31, 2020
• Est. primary completion date: September 30, 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 80 Years

Eligibility

Inclusion Criteria:

1. Age > 18 years, < 80 years

2. female or male

3. Patients are required to undergo EUS-FNA after undergoing imaging examination (MRI, CT, or ultrasonography) which identify that the pancreatic lesions are existing and solid.

4. Agree to attend this study and signed informed consent letter

Exclusion Criteria:

1. bad physical condition, including hemoglobin = 8.0 g/dl, severe cardiorespiratory dysfunction, and so on

2. Coagulopathy (platelet count < 50,000/mm3, international normalized ratio > 1.5) or having taken oral anticoagulation agents such as aspirin or warfarin in the previous week

3. Be rejected by anesthesia

4. Acute pancreatitis in the previous 2 weeks

5. Pregnant or lactation period

6. Psychiatric disease, drug addiction, or other reason for unreliable follow-up or questionnaires

7. Don't agree to attend this study and absence of informed consent

Related Conditions & MeSH terms

• Pancreatic Solid Lesions

Intervention

Procedure:
• wet suction technique
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.
• dry suction technique
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.

Locations

Country	Name	City	State
China	The third Xiangya Hospital of central south University	Changsha	Hunan

Sponsors (1)

Lead Sponsor	Collaborator
The Third Xiangya Hospital of Central South University

Country where clinical trial is conducted

China, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	The primary outcome is defined as the overall diagnosis yield of solid lesions by EUS-FNA with each aspiration technique.	The primary outcome is defined as the overall diagnosis yield of solid lesions by EUS-FNA with each aspiration technique.	20 weeks
Secondary	The second outcome is defined as the diagnose yield of first pass of solid lesions by EUS-FNA with each aspiration technique.	The second outcome is defined as the diagnose yield of first pass of solid lesions by EUS-FNA with each aspiration technique.	20 weeks
Secondary	The third outcome is the diagnose yield in benign solid lesions by EUS-FNA with each aspiration technique.	The third outcome is the diagnose yield in benign solid lesions by EUS-FNA with each aspiration technique.	20 weeks
Secondary	The forth outcome is the diagnose yield in malignant solid lesions by EUS-FNA with each aspiration technique.	The forth outcome is the diagnose yield in malignant solid lesions by EUS-FNA with each aspiration technique.	20 weeks
Secondary	The fifth outcome is the diagnose yield in solid lesions in different parts of the pancreas by EUS-FNA with each aspiration technique.	The fifth outcome is the diagnose yield in solid lesions in different parts of the pancreas by EUS-FNA with each aspiration technique.	20 weeks