Since their introduction, endoscopic ultrasound (EUS)-guided fine-needle aspiration and fine-needle biopsy have become valuable tools in the diagnosis of subepithelial tumors. These techniques have proven to be effective diagnostic methods, with high accuracy and low complication rates. However, several factors can influence the accuracy and diagnostic yield of this procedure. These factors include the relative experience of the endosonographer, the availability of onsite cytopathology services, the method of cytopathology preparation, the location and physical characteristics of the lesion, the sampling techniques employed, and the type and size of needle used. In this chapter, we review the use of EUS-guided sampling for subepithelial tumors with a focus on indicators, prerequisites, choice of instruments, available techniques, and potential complications.
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