PMID- 33015329
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201006
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 8
IP  - 10
DP  - 2020 Oct
TI  - Endoscopic ultrasound-guided through-the-needle microforceps biopsy improves 
      diagnostic yield for pancreatic cystic lesions: a systematic review and 
      meta-analysis.
PG  - E1280-E1290
LID - 10.1055/a-1194-4085 [doi]
AB  - Background and study aims  Given variable diagnostic yield of endoscopic 
      ultrasound (EUS)-guided fine-needle aspiration (FNA) for pancreatic cystic 
      lesions (PCLs), a through-the-needle (TTN) microforceps biopsy device passed 
      through a 19-gauge FNA needle has been devised to improve tissue sampling. This 
      was a systematic review and meta-analysis to evaluate the feasibility, diagnostic 
      yield, and safety of EUS-guided TTN microforceps biopsy for diagnosis of PCLs. 
      Methods  Individualized searches were developed in accordance with PRISMA and 
      MOOSE guidelines. This was a cumulative meta-analysis performed by calculating 
      pooled proportions with rates estimated using random effects models. Measured 
      outcomes included pooled technical success, diagnostic yield, accuracy, and 
      procedure-associated adverse events (AEs) as well as comparison to conventional 
      FNA. Results  Eleven studies (n = 518 patients; mean age 64.13 +/- 5.83 years; 
      58.19 % female) were included. Mean PCL size was 33.39 +/- 3.72 mm with the 
      pancreatic head/uncinate (35.50 %) being the most common location. A mean of 
      2.47 +/- 0.92 forceps passes were performed with a mean of 2.79 +/- 0.81 
      microbiopsies obtained per lesion. Pooled technical success was 97.12 % (95 % CI, 
      93.73-98.71; I (2)  = 34.49) with a diagnostic yield of 79.60 % (95 % CI, 
      72.62-85.16; I (2)  = 56.00), and accuracy of 82.76 % [(95 % CI, 77.80-86.80; I 
      (2)  = 0.00). The pooled serious adverse event rate was 1.08 % (95 % CI, 
      0.43-2.69; I (2)  = 0.00). Compared to conventional FNA, TTN microforceps biopsy 
      resulted in significant improvement in diagnostic yield [OR 4.79 (95 % CI: 
      1.52-15.06; P  = 0.007)] and diagnostic accuracy [OR 8.69 (95 % CI, 1.12-67.12; P 
       = 0.038)], respectively. Conclusions  EUS-guided TTN microforceps biopsy appears 
      to be safe and effective for diagnosis of PCLs with improvement in diagnostic 
      yield and accuracy when compared to FNA alone.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commecial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - McCarty, Thomas
AU  - McCarty T
AD  - Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's 
      Hospital, Harvard Medical School, Boston, Massachusetts, United States.
FAU - Rustagi, Tarun
AU  - Rustagi T
AD  - Division of Gastroenterology and Hepatology, University of New Mexico, 
      Albuquerque, New Mexico, United States.
LA  - eng
PT  - Journal Article
DEP - 20200922
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC7508652
COIS- Competing interests Dr. Rustagi is a consultant for Boston Scientific.
EDAT- 2020/10/06 06:00
MHDA- 2020/10/06 06:01
PMCR- 2020/10/01
CRDT- 2020/10/05 06:22
PHST- 2020/02/20 00:00 [received]
PHST- 2020/04/09 00:00 [accepted]
PHST- 2020/10/05 06:22 [entrez]
PHST- 2020/10/06 06:00 [pubmed]
PHST- 2020/10/06 06:01 [medline]
PHST- 2020/10/01 00:00 [pmc-release]
AID - 10.1055/a-1194-4085 [doi]
PST - ppublish
SO  - Endosc Int Open. 2020 Oct;8(10):E1280-E1290. doi: 10.1055/a-1194-4085. Epub 2020 
      Sep 22.