{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T04:45:43Z","timestamp":1782449143535,"version":"3.54.5"},"reference-count":29,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therap Adv Gastroenterol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background and aims:<\/jats:title>\n                    <jats:p>Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is critical for diagnosing solid lesions. The wet-suction technique, which pre-fills the needle lumen with saline, has been proposed to improve specimen quality compared with conventional dry suction. This study aimed to evaluate the efficacy of wet suction versus dry suction in EUS-TA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This study aimed to evaluate the efficacy of wet suction versus dry suction in EUS-TA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) following PRISMA 2020 guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Electronic searches of PubMed, Embase, Cochrane CENTRAL, and additional databases were performed through January 2025. Primary outcomes were blood contamination, cellularity, and integrity scores; secondary outcomes were diagnostic accuracy and specimen adequacy. Effect sizes were calculated using Hedges\u2019\n                      <jats:italic toggle=\"yes\">g<\/jats:italic>\n                      or risk ratios (RRs) with 95% confidence intervals (CIs).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Seven RCTs (784 patients; 1566 specimens) were included. Wet suction significantly reduced blood contamination (Hedges\u2019\n                      <jats:italic toggle=\"yes\">g<\/jats:italic>\n                      \u2009=\u20090.289, 95% CI: 0.178\u20130.401,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) and improved cellularity (Hedges\u2019\n                      <jats:italic toggle=\"yes\">g<\/jats:italic>\n                      \u2009=\u20090.420, 95% CI: 0.241\u20130.599,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) with low heterogeneity. Integrity score showed no significant difference (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.054). Overall diagnostic accuracy was similar between techniques (RR\u2009=\u20091.025,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.548), but subgroup analysis revealed higher accuracy for wet suction in EUS-fine needle aspiration (FNA; RR\u2009=\u20091.162,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.001). Specimen adequacy did not differ significantly (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.074).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Wet suction improves sample quality by reducing blood contamination and increasing cellularity, with potential diagnostic benefit in FNA procedures. Effects on integrity and adequacy remain inconclusive. Larger, standardized trials are warranted to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17562848261458692","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T17:41:21Z","timestamp":1782236481000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of wet suction on specimen quality and diagnostic accuracy in EUS-guided tissue acquisition: a systematic review and meta-analysis of randomized controlled trials"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3918-4540","authenticated-orcid":false,"given":"Po-Feng","family":"Huang","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan"},{"name":"Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung-Chun","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tien-Yu","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng-Jen","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Wei","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Ting","family":"Kuo","sequence":"additional","affiliation":[{"name":"Division of Endoscopy, Department of Integrated Diagnostics and Therapeutics, National Taiwan University Hospital, National Taiwan University College of Medicine, No. 7, Chung Shan S. Rd. (Zhongshan S. Rd.), Zhongzheng Dist., Taipei City 100, Taiwan"},{"name":"Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7226-4820","authenticated-orcid":false,"given":"Hsuan-Wei","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical University, No. 325, Sec. 2, Chenggong Rd., Neihu District, Taipei City 114202, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"issue":"3","key":"e_1_3_4_2_2","first-page":"257","article-title":"Endoscopic ultrasound-guided tissue acquisition beyond the pancreas","volume":"36","author":"Manthopoulou E","year":"2023","unstructured":"Manthopoulou E, Ramai D, Ioannou A, et al. Endoscopic ultrasound-guided tissue acquisition beyond the pancreas. 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RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019; 366: l4898.","journal-title":"BMJ"},{"key":"e_1_3_4_16_2","unstructured":"Higgins JPT Li T Deeks JJ. Chapter 6: choosing effect measures and computing estimates of effect. In: Cochrane handbook for systematic reviews of interventions. Version 6.2 https:\/\/training.cochrane.org\/handbook\/current\/chapter-06 (2019 accessed 13 August 2021)."},{"key":"e_1_3_4_17_2","unstructured":"Higgins JPT Eldridge S Li T. Chapter 23: including variants on randomized trials. In: Cochrane handbook for systematic reviews of interventions. 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Front Med (Lausanne) 2024; 11: 1422600.","journal-title":"Front Med (Lausanne)"},{"issue":"3","key":"e_1_3_4_27_2","article-title":"Heparin priming of EUS-FNA needles does not adversely affect tissue cytology or immunohistochemical staining","volume":"6","author":"Diehl DL","year":"2018","unstructured":"Diehl DL, Mok SR, Khara HS, et al. Heparin priming of EUS-FNA needles does not adversely affect tissue cytology or immunohistochemical staining. 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