{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T05:32:24Z","timestamp":1768282344377,"version":"3.49.0"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T00:00:00Z","timestamp":1736380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["23K15044"],"award-info":[{"award-number":["23K15044"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Endoscopic ultrasound\u2010guided fine\u2010needle aspiration\/biopsy (EUS\u2010FNA\/B) is the gold standard for diagnosing gastric subepithelial lesions (SELs), but diagnosing lesions smaller than 20\u2009mm remains challenging. We developed traction\u2010assisted EUS\u2010FNB (TA\u2010EUS\u2010FNB) using the clip\u2010with\u2010thread method to enhance diagnostic accuracy by stabilizing the lesion and providing counter\u2010traction for easier needle access. This study evaluates the effectiveness of TA\u2010EUS\u2010FNB in diagnosing small gastric SELs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective, randomized, controlled cross\u2010over trial (August 2019\u2013November 2022), 30 patients with gastric SELs &lt;20\u2009mm were randomized to undergo TA\u2010EUS\u2010FNB or conventional EUS\u2010FNB. Each patient underwent four punctures, two per method. The primary end\u2010point was the adequate tissue sampling rate for both techniques. Secondary end\u2010points included diagnostic yield and performance (sensitivity and specificity) in distinguishing gastrointestinal stromal tumors (GISTs) from non\u2010GISTs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean tumor size was 15.0\u2009mm, with diagnoses comprising GISTs (<jats:italic>n<\/jats:italic>\u2009=\u200915, 50%), leiomyomas (<jats:italic>n<\/jats:italic>\u2009=\u20098, 26.7%), schwannomas (<jats:italic>n<\/jats:italic>\u2009=\u20092, 6.7%), aberrant pancreas (<jats:italic>n<\/jats:italic>\u2009=\u20093, 10%), and inflammation (<jats:italic>n<\/jats:italic>\u2009=\u20092, 6.7%). TA\u2010EUS\u2010FNB demonstrated a significantly higher adequate\u2010tissue sampling rate (90% vs. 66.7%, <jats:italic>P<\/jats:italic>\u2009=\u20090.035) and\u00a0diagnostic yield (86.7% vs. 63.3%, <jats:italic>P<\/jats:italic>\u2009=\u20090.037) than conventional EUS\u2010FNB. Sensitivity (86.7%, 95% confidence interval [CI] 62.1\u201396.3% vs. 66.7%, 95% CI 41.7\u201384.8%; <jats:italic>P<\/jats:italic>\u2009=\u20090.20) and specificity (100%, 95% CI 79.6\u2013100% vs. 100%, 95% CI 79.6\u2013100%) were comparable between the methods. No adverse events were observed in the study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>TA\u2010EUS\u2010FNB demonstrated superior tissue sampling rates and diagnostic yield for SELs &lt;20\u2009mm compared to conventional EUS\u2010FNB, making it a viable option. Controlling lesion mobility is essential for successful EUS\u2010FNB in small SELs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/den.14977","type":"journal-article","created":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T06:41:03Z","timestamp":1736491263000},"page":"512-520","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Traction\u2010assisted endoscopic ultrasound\u2010guided fine\u2010needle biopsy using the clip\u2010with\u2010thread method for small gastric subepithelial lesions: Randomized controlled trial (with video)"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9567-9738","authenticated-orcid":false,"given":"Yosuke","family":"Minoda","sequence":"first","affiliation":[{"name":"Department of Medicine and Bioregulatory Science Graduate School of Medical Sciences Kyushu University  Fukuoka Japan"},{"name":"Department of Endoscopic Diagnostics and Therapeutics Kyushu 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