Efficacy of TBNA needles for EBUS during fiberoptic bronchoscopy?
Abstract views: 125
/ 
PDF downloads: 145
DOI:
https://doi.org/10.26900/hsq.2.3.04Keywords:
Conventional transbronchial needle aspiration, endobronchial ultrasound, fiberoptic bronchoscopyAbstract
Conventional transbronchial needle aspiration (cTBNA) biopsy is a diagnostic minimally invasive technique applied using fibreoptic bronchoscopy (FOB) in the evaluation of mediastinal/hilar lymph nodes. With the development of endobronchial ultrasound (EBUS) devices, transbronchial aspiration needles have been revised for use according to the EBUS guidelines. The main aim of this research was to evaluate the diagnostic success of transbronchial aspiration needles that was produced for EBUS when it was applied with FOB instead of conventional TBNA. A retrospective examination was made with the data of 35 patients applied with FOB TBNA, using needles specifically designed for EBUS and 36 patients with conventional TBNA (cTBNA group), for lung cancer staging or the diagnosis of mediastinal lymphadenopathy between November 2018 and November 2019. Seventy-two and sixty procedures performed on 71 patients were included in the study. Diagnostic efficiency for TBNA and cTBNA groups were 91.4% and 83.3%, respectively. Conventional TBNA is still acceptable when the low cost and ease of application are taken into consideration. In conclusion, improvement of current conventional TBNA needles similar to EBUS-TBNA needles for more efficient aspiration capacity could be the first stepto increasing the TBNA diagnostic yield. Nevertheless, further studies are needed to confirm our results.
Downloads
References
- Vitale C, Galderisi A, Maglio A, Laperuta P, Di Crescenzo RM, Selleri C, et al. Diagnostic yield and safety of C-TBNA in elderly patients with lung cancer. Open Med (Wars). 2016;11(1):477-81. doi: 10.1515/med-2016-0084.
- Schieppati E. La puncion mediastinal a traves del espolon traqueal. Rev Asoc Med Argent. 1949;663:497-9.
- Wang KP, Marsh BR, Summer WR, Terry PB, Erozan YS, Baker RR. Transbronchial needle aspiration for diagnosis of lung cancer. Chest. 1981;80(1):48-50.
- Yasufuku K, Chiyo M, Sekine Y, Chhajed PN, Shibuya K, Iizasa T, et al. Real-time endobronchial ultrasound-guided transbronchial needle aspiration of mediastinal and hilar lymph nodes. Chest. 2004;126(1):122-8. doi: 10.1378/chest.126.1.122.
- Yang H, Zhang Y, Wang KP, Ma Y. Transbronchial needle aspiration: Development history, current status and future perspective. J Thorac Dis. 2015;7(4):279-86. doi: 10.3978/j.issn.2072- 1439.2015.11.36.
- Wallace MB, Pascual JM, Raimondo M, Woodward TA, McComb BL, Crook JE, et al. Minimally invasive endoscopic staging of suspected lung cancer. JAMA. 2008;299(5):540-6. doi: 10.1001/ jama.299.5.540.
- Cicek T, Ozturk A, Yılmaz A, Aktas Z, Demirag F, Akyurek N. Adequacy of EBUS-TBNA specimen for mutation analysis of lung cancer. Clin Respir J. 2019;13(2):92-7. doi: 10.1111/crj.12985.
- Silvestri GA, Gonzalez AV, Jantz MA, Margolis ML, Gould MK, Tanoue LT, et al. Methods for staging non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143(5):211-50. doi: 10.1378/chest.12-2355.
- Herth F, Becker HD, Ernst A. Conventional vs endobronchial ultrasound-guided transbronchial needle aspiration: A randomized trial. Chest 2004;125:322-5. doi: 10.1378/chest.125.1.322.
- Cornelissen CG, Dapper J, Dreher M, Müller T. Endobronchial ultrasound-guided transbronchial needle aspiration under general anesthesia versus bronchoscopist-directed deep sedation: A retrospective analysis. Endosc Ultrasound. 2019;8(3):204-8. doi: 10.4103/eus.eus_65_18.
- Zhang L, Wu H, Wang G. Endobronchial ultrasonography using a guide sheath technique for diagnosis of peripheral pulmonary lesions. Endosc Ultrasound. 2017;6:292-9. doi: 10.4103/ eus.eus_48_17.
- Gupta D, Dadhwal DS, Agarwal R, Gupta N, Bal A, Aggarwal AN. Endobronchial ultrasound guided transbronchial needle aspiration vs conventional transbronchial needle aspiration in the diagnosis of sarcoidosis. Chest. 2014;146(3):547-56. doi: 10.1378/chest.13-2339.
- Dziedzic DA, Peryt A, Orlowski T. The role of EBUS-TBNA and standard bronchoscopic modalities in the diagnosis of sarcoidosis. Clin Respir J. 2017;11(1):58-63. doi: 10.1111/crj.12304.
- Öztürk Ö, Sandal A, Karahan S, Er B, Önder S, Köksal D, et al. Diagnostic yield of conventional transbronchial needle aspiration biopsy (C-TBNA) without an on-site cytopathologist: Experience of 363 procedures in 219 patients. Tuberk Toraks. 2016;64(2):137 43. doi: 10.5578/tt.10905.
- Mountain CF, Dresler CM. Regional lymph node classification for lung cancer staging. Chest 1997;111:1718-23. doi: 10.1378/chest.111.6.1718.
- Holty JE, Kuschner WG, Gould MK. Accuracy of transbronchial needle aspiration for mediastinal staging of non-small cell lung cancer: A meta-analysis. Thorax. 2005;60:949–55. doi: 10.1136/thx.2005.041525.
- Haponik EF, Cappellari JO, Chin R, Adair NE, Lykens M, Alford PT, et al. Education and experience improve transbronchial needle aspiration performance. Am J Respir Crit Care Med. 1995;151(6):1998-2002. doi: 10.1164/ajrccm.151.6.7767550.
- Wang KP, Browning R. Transbronchial needle aspiration with or without endobronchial ultrasound. Thoracic Cancer. 2010;1:87-93. doi: 10.1111/j.1759-7714.2010.00015.x.
- Gupta D, Dadhwal DS, Agarwal R, Gupta N, Bal A, Aggarwal AN. Endobronchial ultrasound guided transbronchial needle aspiration vs conventional transbronchial needle aspiration in the diagnosis of sarcoidosis. Chest. 2014;146(3):547-56. doi: 10.1378/chest.13-2339.
- Bandyopadhyay D, Panchabhai TS, Mehta AC. EBUS-TBNA for the Diagnosis of lymphoma. Still an Achilles Heel. Ann Am Thorac Soc. 2015;12(9):1263-4. doi: 10.1513/AnnalsATS.201507- 403ED.
- Mehta RM, Aurangabadbadwalla R, Singla A, Loknath C, Munavvar M. Endobronchial ultrasound-guided mediastinal lymph node forceps biopsy in patients with negative rapidon- site-evaluation: A new step in the diagnostic algorithm. Clin Respir J. 2020;14(4):314-9. doi: 10.1111/crj.13133.
- Kennedy MP, Jimenez CA, Bruzzi JF, Mhatre AD, Lei X, Giles FJ, et al. Endobronchial ultrasoundguided transbronchial needle aspiration in the diagnosis of lymphoma. Thorax. 2008;63(4):360- 5. doi: 10.1136/thx.2007.084079.
- Senturk A, Babaoglu E, Kilic H, Hezer H, Dogan HT, Hasanoglu HC, et al. Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of lymphoma. Asian Pac J Cancer Prev. 2014;15(10):4169-73. doi: 10.7314/apjcp.2014.15.10.4169.
- Steinfort DP, Conron M, Tsui A, Pasricha SR, Renwick WE, Antippa P, et al. Endobronchial ultrasound-guided transbronchial needle aspiration for the evaluation of suspected lymphoma. J Thorac Oncol. 2010;5(6):804-9. doi: 10.1097/jto.0b013e3181d873be.
- Bilaçeroğlu S, Günel O, Eriş N, Cağirici U, Mehta AC. Transbronchial needle aspiration in diagnosing intrathoracic tuberculous lymphadenitis. Chest. 2004;126(1):259-67. doi: 10.1378/chest.126.1.259.
- Liran L, Rottem K, Gregorio FZ, Avi A, Neville B. A novel, stepwise approach combining conventional and endobronchial ultrasound needle aspiration for mediastinal lymph node sampling. Endosc Ultrasound. 2019;8(1):31-5. doi: 10.4103/eus.eus_29_17.
- Hergott CA, Maceachern P, Stather DR, Tremblay A. Repair costs for endobronchial ultrasound bronchoscopes. J Bronchology Interv Pulmonol. 2010;17(3):223-7. doi: 10.1097/ LBR.0b013e3181e77280.
- Oki M, Saka H, Kitagawa C, Tanaka S, Shimokata T, Kawata Y, et al. Real-time endobronchial ultrasound-guided transbronchial needle aspiration is useful for diagnosing sarcoidosis. Respirology. 2007;12(6):863-8. doi: 10.1111/j.1440-1843.2007.01145.x.
- Kennedy MP, Jimenez CA, Bruzzi JF, Mhatre AD, Lei X, Giles FJ, et al. Endobronchial ultrasoundguided transbronchial needle aspiration in the diagnosis of lymphoma. Thorax. 2008;63(4):360- 5. doi: 10.1136/thx.2007.084079.
- Navani N, Nankivell M, Nadarajan P, Pereira SP, Kocjan G, Janes SM. The learning curve for EBUSTBNA. Thorax. 2011;66(4):352-3. doi: 10.1136/thx.2010.146407.
- Wahidi MM, Hulett C, Pastis N, Shepherd RW, Shofer SL, Mahmood K, et al. Learning
experience of linear endobronchial ultrasound among pulmonary trainees. Chest. 2014;145(3):574-8. doi: 10.1378/chest.13-0701.
- Kemp SV, El Batrawy SH, Harrison RN, Skwarski K, Munavvar M, Rosell A, et al. Learning curves for endobronchial ultrasound using cusum analysis. Thorax. 2010;65(6):534-8. doi: 10.1136/thx.2009.127274.
- Ulasli SS, Kupeli E. EBUS-TBNA: Popular but not universal. Respirology. 2014;19(2):288-9. doi: 10.1111/resp.12232.
- Phua GC, Rhee KJ, Koh M, Loo CM, Lee P. A strategy to improve the yield of transbronchial needle aspiration. Surg Endosc. 2010;24(9):2105-9. doi: 10.1007/s00464-010-0906-4.
- Kupeli E, Memis L, Ozdemirel TS, Ulubay G, Akcay S, Eyuboglu FO. Transbronchial needle aspiration “by the books”. Ann Thorac Med. 2011;6(2):85-90. doi: 10.4103/1817-1737.78427.
- Küpeli E, Cörüt R, Memiş L, Eyüboğlu FO. Transbronchial needle aspiration: A tool for a community bronchoscopist. J Bronchology Interv Pulmonol. 2012;19(2):115-20. doi: 10.1097/
LBR.0b013e31824dd19a.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Holistence Publications
This work is licensed under a Creative Commons Attribution 4.0 International License.
When the article is accepted for publication in the HSQ authors transfer all copyright in the article to the Holistence Academy Ar-Ge Yazılım Yayıncılık Eğitim Danışmanlık ve Organizasyon Ticaret Ltd. Şti.The authors reserve all proprietary right other than copyright, such as patent rights.
Everyone who is listed as an author in this article should have made a substantial, direct, intellectual contribution to the work and should take public responsibility for it.
This paper contains works that have not previously published or not under consideration for publication in other journals.
