Background: The EUS-guided fine needle aspiration (EUS-FNA) procedure has a low rate of side effects, excellent sensitivity, and specificity, and allows for cytological confirmation of imaging findings. It is thought that the quality and diagnostic sample yield are improved during EUS-guided FNA (EUS-FNA) when a suction syringe and stylet are used.

Objectives: To compare the diagnostic yield and cytological properties of samples collected by EUS-FNA with and without suction and stylet.

Materials and Methods: 62 individuals who had been recommended for EUS-FNA due to solid upper gastrointestinal lesions participated in this comparative study. With and without a suction syringe and stylet, each lesion was sampled twice. A predetermined set of cytological criteria was used to evaluate the samples' quality.

Results: In this comparative study, 62 patients were prospectively enrolled, and 44 underwent EUS-FNA at the pancreas, 11 at the common bile duct, 5 at the stomach, and 2 at the lymph nodes. With stylet and suction, 29/62 [46.8%] vs. without stylet and suction, 29/62 [46.8%], P = 0.901), interim analysis showed that no difference in the overall diagnostic outcome of malignancy between the specimens collected using the two procedures. Regarding cellularity (P = 0.494), contamination (P = 0.511), and specimen sufficiency (P = 0.471), there was no difference. The no suction, no stylet approach considerably reduced blood contamination (P<0.0001).

Conclusions: Both techniques offered comparable diagnostic outcomes. However, no suction, no stylet technique showed less blood contamination resulting in a sample of higher quality.