Methodological and Technical Aspects of EUS-Guided Fine Needle Aspiration of the Upper Digestive Tract Lesions

Aim. Analysis of the results of our own experience of EUS-guided fi ne-needle aspiration (EUS-FNA) of digestive tract lesions, depending on the technical and methodological aspects.

Materials and methods. From 2007 to July 2019, the EUS-FNA was performed in 86 patients. Aspirating and ProCore needles of various calibers were used. Punctures were performed once (54), two- (20), three- (8) and four times (4) both with and without aspiration.

Results and discussion. Material suitable for histological examination was obtained in 86% of patients: with a single puncture — in 83.3% of cases, double — in 91.3%, triple — in 100%, four times — not obtained. Using 19G needles, the material was obtained in 80.5%, 22G in 93%, 25G in 100% of cases. Punctures were successful in 90.5% of patients with pancreatic lesions, in 75% of patients with subepithelial lesions, in 80% of cases with abdominal and retroperitoneal lesions, in all patients with lymphadenopathy, mediastinal and liver lesions. With aspiration, punctures were successful in 85.5% of cases, without aspiration in 100% (3/3). With the combined method (with and without aspiration), the material obtained in diff erent modes in 11 patients was equally sufficient for histological examination. It was also noted that one of the Fujifi lm echoendoscopes used for performing the EUS-FNA has an inconvenient design of the biopsy channel distal part. A surgery was performed on 50 out of 86 patients; in 42 (84%) of them, the EUS-FNA material was suitable for performing a morphological examination. The histological examination results conformity of the material obtained by fi ne-needle aspiration and surgical material was 88.1% (37/42).

Conclusion. It is necessary to consider many factors to obtain the most eff ective results in the EUS-FNA, since none of them is prevailing.

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