Comparison of Three Tissue Acquiring Techniques During EUS Guided Biopsies of Solid Pancreatic Tumors.
| Status: | Recruiting |
|---|---|
| Conditions: | Cancer, Cancer, Cancer, Pancreatic Cancer |
| Therapuetic Areas: | Oncology |
| Healthy: | No |
| Age Range: | 18 - 80 |
| Updated: | 10/24/2018 |
| Start Date: | September 11, 2017 |
| End Date: | January 31, 2021 |
| Contact: | Nancy Casner, CCRC |
| Email: | nancy.casner@ttuhsc.edu |
| Phone: | 9155255822 |
Comparison of Three Different Tissue Acquisition Techniques During Endoscopic Ultrasound-guide Fine Needle Biopsies of Solid Pancreatic Tumors: A Randomized Single Blind Clinical Trial.
The study's aim is to prospectively compare three different tissue acquisition techniques
during EUS guided pancreatic solid lesions biopsies.
during EUS guided pancreatic solid lesions biopsies.
Endoscopic ultrasound guided fine-needle aspiration (EUS-FNA) has been used since 1990's for
the diagnosis and staging of esophageal, gastric, duodenal, pancreatobiliary, rectal
mediastinal lesions and intra-abdominal lymphadenopathy. Studies have shown a variable range
of specimen adequacy when performing pancreatic biopsies with the standard fine needle
aspiration (FNA) needles with this modality. There are several factors that affect the
overall diagnostic yield of this procedure, such as endosonographer experience, presence of
cytopathologist during the procedure, the needle diameter and the number of passes. In this
study we will compare the yield of recently available fine biopsy needles (FNB) using three
different techniques to obtain samples from pancreatic lesions. The three techniques to be
compared in this study are: stylet slow pull (SP) vs dry suction (DS) vs wet suction (WS).
wall cells.
In the "suction technique" the stylet of the needle can be left in place or removed before
puncturing the lesion. Once the needle is inside the target, negative pressure is applied
through a 10 or 20 cc syringe connected to the needle.
The wet suction technique consists of flushing of the needle with 5 ml of saline solution to
replace the column of air within the lumen of needle with saline solution before needle
aspiration. Once the needle is flushed, negative pressure is applied with a 10 or 20 cc
syringe connected to the needle.
In the slow pull technique, the stylet is left in place in the needle and is slightly
retracted prior to puncturing the lesion. Once the needle is inside the target, the stylet is
pushed completely into the needle to remove any contaminant cells and several back and forth
movements are done while slowly withdrawing the stylet.
the diagnosis and staging of esophageal, gastric, duodenal, pancreatobiliary, rectal
mediastinal lesions and intra-abdominal lymphadenopathy. Studies have shown a variable range
of specimen adequacy when performing pancreatic biopsies with the standard fine needle
aspiration (FNA) needles with this modality. There are several factors that affect the
overall diagnostic yield of this procedure, such as endosonographer experience, presence of
cytopathologist during the procedure, the needle diameter and the number of passes. In this
study we will compare the yield of recently available fine biopsy needles (FNB) using three
different techniques to obtain samples from pancreatic lesions. The three techniques to be
compared in this study are: stylet slow pull (SP) vs dry suction (DS) vs wet suction (WS).
wall cells.
In the "suction technique" the stylet of the needle can be left in place or removed before
puncturing the lesion. Once the needle is inside the target, negative pressure is applied
through a 10 or 20 cc syringe connected to the needle.
The wet suction technique consists of flushing of the needle with 5 ml of saline solution to
replace the column of air within the lumen of needle with saline solution before needle
aspiration. Once the needle is flushed, negative pressure is applied with a 10 or 20 cc
syringe connected to the needle.
In the slow pull technique, the stylet is left in place in the needle and is slightly
retracted prior to puncturing the lesion. Once the needle is inside the target, the stylet is
pushed completely into the needle to remove any contaminant cells and several back and forth
movements are done while slowly withdrawing the stylet.
Inclusion Criteria:
1. Ages between 18-80 years old
2. Sex: male or female
3. Patients who require EUS and tissue sampling of solid pancreatic solid lesions (size
>1 cm) anywhere in the pancreas (head, uncinate, neck, body or tail)
4. Patients who are able to give consent
Exclusion Criteria:
1. Pregnant female
2. Coagulation disorders (platelets < 50,000/mm3, INR > 2)
3. Patients with acute pancreatitis in the immediate 2 weeks prior to the procedure.
4. Patients with chronic pancreatitis
5. Cardiorespiratory dysfunction that precludes sedation.
6. Unable to provide informed consent
7. Previous chemotherapy or radiotherapy for pancreatic neoplasm
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