title: Forward-viewing versus oblique-viewing echoendoscopes in the diagnosis of upper GI subepithelial lesions with EUS-guided FNA: a prospective, randomized, crossover study.
abstract: BACKGROUND
  The role of the forward-viewing echoendoscope compared with the oblique-viewing echoendoscope for EUS-guided FNA (EUS-FNA) of upper GI subepithelial lesions has not been defined.
  
  
  OBJECTIVE
  To compare the diagnostic yield and clinical efficacy of EUS-FNA by using the 2 echoendoscopes in the same upper GI subepithelial lesion.
  
  
  METHODS
  Prospective, randomized, crossover study.
  
  
  METHODS
  Tertiary-care medical center.
  
  
  METHODS
  Forty-one patients with an upper GI subepithelial lesion.
  
  
  METHODS
  All patients first underwent EUS-FNA with a 19-gauge needle by using both echoendoscopes, based on random selection. When required, 22-gauge or 25-gauge needles were used additionally.
  
  
  METHODS
  Comparison of diagnostic yield, tissue sample area, puncture success rates, procedure time, and adverse events.
  
  
  RESULTS
  Forty-one patients (median lesion size 22 mm, range 15-63 mm) were enrolled. Rates of histologic diagnosis were 80.5% (33/41) and 73.2% (30/41) (P=.453) by using forward-viewing and oblique-viewing echoendoscopes, respectively. Median tissue sample area in GI stromal tumors (n=22) obtained with the forward-viewing echoendoscope was larger than with the oblique-viewing echoendoscope (2.46 mm2 vs 1.00 mm2; P=.046). Puncture success rates were 39 of 41 (95.1%) and 35 of 41 (85.4%; P=.289) with forward-viewing and oblique-viewing echoendoscopes, respectively. Median procedure time was 21 minutes with the forward-viewing echoendoscope and 27 minutes with the oblique-viewing echoendoscope (P=.009). An infectious adverse event occurred in a patient and was treated with antibiotics.
  
  
  CONCLUSIONS
  Small sample size.
  
  
  CONCLUSIONS
  Diagnostic yield did not differ between the 2 echoendoscopes. However, tissue sample area and procedure time were superior with the forward-viewing echoendoscope.
authors: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Ippei
authors: I
authors: Matsuzaki
authors: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Ryoji
authors: R
authors: Miyahara
authors: Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan.
authors: Yoshiki
authors: Y
authors: Hirooka
authors: Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan.
authors: Kohei
authors: K
authors: Funasaka
authors: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Eizaburo
authors: E
authors: Ohno
authors: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Masanao
authors: M
authors: Nakamura
authors: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Hiroki
authors: H
authors: Kawashima
authors: Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya, Japan.
authors: Akiko
authors: A
authors: Nukaga
authors: Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya, Japan.
authors: Yoshie
authors: Y
authors: Shimoyama
authors: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan.
authors: Hidemi
authors: H
authors: Goto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology; D002828:Choristoma / Q000473:pathology; D018592:Cross-Over Studies; D004379:Duodenal Neoplasms / Q000473:pathology; D020776:Endoscopes, Gastrointestinal; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000009:adverse effects / Q000295:instrumentation*; D016099:Endoscopy, Gastrointestinal / Q000295:instrumentation*; D004938:Esophageal Neoplasms / Q000473:pathology; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000473:pathology*; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology; D006801:Humans; D007889:Leiomyoma / Q000473:pathology; D008223:Lymphoma / Q000473:pathology; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010179:Pancreas; D011446:Prospective Studies; D011677:Punctures / Q000295:instrumentation; D013274:Stomach Neoplasms / Q000473:pathology