Wet- versus dry-suction techniques for EUS-FNA of solid lesions: A systematic review and meta-analysis

Daryl Ramai, Jameel Singh, Tarik Kani, Mohamed Barakat, Saurabh Chandan, Olivia Brooks, Andrew Ofosu, Shahab Khan, Banreet Dhindsa, Amaninder Dhaliwal, Eduardo Quintero, Derrick Cheung, Antonio Facciorusso, Stephanie Mcdonough, Douglas Adler

Research output: Contribution to journalReview articlepeer-review

Abstract

The optimal sampling techniques for EUS-FNA remain unclear and have not been standardized. To improve diagnostic accuracy, suction techniques for EUS-FNA have been developed and are widely used among endoscopists. The aim of this study was to compare wet-suction and dry-suction EUS-FNA techniques for sampling solid lesions. We performed a comprehensive literature search of major databases (from inception to June 2020) to identify prospective studies comparing wet-suction EUS-FNA and dry-suction EUS-FNA. Specimen adequacy, sample contamination, and histologic accuracy were assessed by pooling data using a random-effects model expressed in terms of odds ratio (OR) and 95% confidence interval (CI). Six studies including a total of 418 patients (365 wet suction vs. 377 dry suction) were included in our final analysis. The study included a total of 535 lesions (332 pancreatic lesions and 203 nonpancreatic lesions). The pooled odds of sample adequacy was 3.18 (CI: 1.82-5.54, P = 0.001) comparing wet- and dry-suction cohorts. The pooled odds of blood contamination was 1.18 (CI: 0.75-1.86, P = 0.1). The pooled rate for blood contamination was 58.33% (CI: 53.65%-62.90%) in the wet-suction cohort and 54.60% (CI 49.90%- 59.24%) in the dry-suction cohort (P = 0.256). The pooled odds of histological diagnosis was 3.68 (CI 0.82-16.42, P = 0.1). Very few adverse events were observed and did not have an impact on patient outcomes using either method. EUS-FNA using the wet-suction technique offers higher specimen quality through comparable rates of blood contamination and histological accuracy compared to dry-suction EUS-FNA.

Original languageEnglish (US)
Pages (from-to)319-324
Number of pages6
JournalEndoscopic Ultrasound
Volume10
Issue number5
DOIs
StatePublished - 2021

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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