Antonio Facciorusso1, Elisa Stasi2, Marianna Di Maso1, Gaetano Serviddio3, Mohammed Salah Ali Hussein1,4, Nicola Muscatiello1. 1. Gastroenterology Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy. 2. Gastroenterology Unit, IRCCS Saverio De Bellis, Castellana Grotte (Ba), Italy. 3. Internal Medicine Unit, University of Foggia, Italy. 4. Department of Internal Medicine, Al-Azhar University, Cairo, Egypt.
Abstract
BACKGROUND: Robust data in favour of a clear superiority of 22 versus 25 Gauge needles for endoscopic ultrasound-guided fine needle aspiration are still lacking. OBJECTIVE: We aimed to compare the diagnostic sensitivity, specificity and safety of these two needles for endoscopic ultrasound-guided fine needle aspiration of solid pancreatic lesions. METHODS: A computerized bibliographic search was restricted to randomized controlled trials only. Pooled effects were calculated using a random-effects model and expressed in terms of risk ratio and 95% confidence interval. RESULTS: We analysed seven trials with 689 patients and 732 lesions (295 sampled with 22 Gauge needle, 309 with 25 Gauge needle, and 128 with both needles). A non-significant superiority of 25 Gauge in terms of pooled sensitivity (risk ratio: 0.93, 0.91-0.95 versus 0.89, 0.85-0.94 of 22 Gauge needle; p = 0.13) and no difference in terms of specificity (1.00, 0.98-1.00 in both groups; p = 0.85) were observed. Sample adequacy was similar between the two devices (risk ratio: 1.03, 0.99-1.06; p = 0.15). Very few adverse events were observed and did not impact on patient outcomes. CONCLUSION: Our meta-analysis reveals non-superiority of 25 Gauge over 22 Gauge; hence no definitive recommendations over the use of one particular device can be made.
BACKGROUND: Robust data in favour of a clear superiority of 22 versus 25 Gauge needles for endoscopic ultrasound-guided fine needle aspiration are still lacking. OBJECTIVE: We aimed to compare the diagnostic sensitivity, specificity and safety of these two needles for endoscopic ultrasound-guided fine needle aspiration of solid pancreatic lesions. METHODS: A computerized bibliographic search was restricted to randomized controlled trials only. Pooled effects were calculated using a random-effects model and expressed in terms of risk ratio and 95% confidence interval. RESULTS: We analysed seven trials with 689 patients and 732 lesions (295 sampled with 22 Gauge needle, 309 with 25 Gauge needle, and 128 with both needles). A non-significant superiority of 25 Gauge in terms of pooled sensitivity (risk ratio: 0.93, 0.91-0.95 versus 0.89, 0.85-0.94 of 22 Gauge needle; p = 0.13) and no difference in terms of specificity (1.00, 0.98-1.00 in both groups; p = 0.85) were observed. Sample adequacy was similar between the two devices (risk ratio: 1.03, 0.99-1.06; p = 0.15). Very few adverse events were observed and did not impact on patient outcomes. CONCLUSION: Our meta-analysis reveals non-superiority of 25 Gauge over 22 Gauge; hence no definitive recommendations over the use of one particular device can be made.
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