Comparison of Suction Techniques for EUS-Guided Tissue Acquisition: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

Background Despite the widespread use of endoscopic ultrasound (EUS)-guided tissue acquisition, choice optimal suction technique remains a debate. Multiple studies have shown conflicting results with respect to four techniques: Dry (DS), no (NS), stylet slow pull (SSP) and wet (WS). Thus, present network meta-analysis (NMA) was conducted compare diagnostic yields above techniques during EUS-guided acquisition. Methods A comprehensive literature search from 2010 March 2022 done for randomized comparing aspirated sample outcome various techniques. Both pairwise meta-analyses were performed analyze outcomes: adequacy, moderate high cellularity, gross bloodiness, accuracy. Results total 16 (n = 2048 patients) included in final NMA. WS associated lower odd bloodiness compared DS [Odds ratio (OR) 0.50, 95% confidence interval (CI) 0.24 – 0.97). There significant difference between methods cellularity On meta-regression, adjust effect needle type, comparable terms when adjusted FNA needle. Surface under cumulative ranking analysis ranked as best modality all outcomes. Conclusion The NMA did not show superiority any specific sampling regard quality or accuracy, low estimates.