Effectiveness and safety of endobronchial ultrasound-transbronchial needle aspiration: a systematic review

Varela-Lema, Leonor; Fernández-Villar, Alberto; Ruano-Raviña, Alberto

doi:10.1183/09031936.00097908

Cited by 377 publications

(268 citation statements)

References 36 publications

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“…To the best of our knowledge, there are 2 systematic reviews and 2 Japanese survey studies in the literature describing the serious complications associated with EBUS-TBNA. 2,4,12,14 The serious complication rate of EBUS-TBNA was determined to be 0.16% in the present study.…”

Section: Discussionmentioning

confidence: 98%

“…1 It is a noninvasive technique with minor complications of agitation, cough, and bleeding at the puncture site. 2,3 Varela-Lema et al 2 published a systematic review and noted no important complications related to Ͼ1,500 EBUS-TBNA procedures. A meta-analysis on EBUS-TBNA reported a complication rate of 2 in 1,299 cases (0.15%), with only 1 case showing pneumothorax requiring drainage as a major complication.…”

Section: Introductionmentioning

confidence: 99%

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Complications of Convex-Probe Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Multi-Center Retrospective Study

Çağlayan

Yılmaz²,

Bilaçeroğlu³

et al. 2015

Respir Care

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BACKGROUND: Infrequent serious complications of convex-probe endobronchial ultrasoundguided transbronchial needle aspiration (EBUS-TBNA) have been reported. The aim of this study was to assess serious complications related to convex-probe EBUS-TBNA and to determine the complication rate in a large group of subjects. METHODS: In this retrospective study, a 15-item questionnaire on features of cases with EBUS-TBNA complications was sent to experienced bronchoscopists performing convex-probe EBUS-TBNA at 3 pulmonary centers. The medical records were then reviewed by these bronchoscopists to complete the questionnaire. Hemorrhage responsive to topical treatment, temporary laryngospasm/bronchospasm, transient oxygen desaturation, and fever lasting <24 h were excluded. Only complications requiring further treatment/intervention were considered serious. The rate of serious complications was calculated from the obtained data. RESULTS: In a total of 3,123 cases within a 5-y period, EBUS-TBNA was performed for staging lung cancer in 15.8%, diagnosis in 67.5%, and diagnosis and staging in 16.3%. Of the 3,123, 11.6% had parenchymal lesions adjacent to major airways. EBUS-TBNA was performed 11,753 times (3.76/case) at 6,115 lymph node stations and lesions (1.92/station or lesion). Five serious complications were recorded (0.16%): fever lasting >24 h, infection of bronchogenic cyst, mediastinal abscess, pericarditis, and pneumomediastinitis with empyema, each in one case. Four complications occurred in cases diagnosed with benign disease by EBUS-TBNA. All complications were treated with broad-spectrum antibiotics. Four subjects were hospitalized for 21.7 ؎ 20.7 d. CONCLUSIONS: Convex-probe EBUS-TBNA is a safe method in general. However, serious complications, including infections, can be encountered rarely. All precautions should be taken for complications before and during the procedure.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Complications of Convex-Probe Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Multi-Center Retrospective Study

Çağlayan

Yılmaz²,

Bilaçeroğlu³

et al. 2015

Respir Care

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“…There are many reports confirming the diagnostic accuracy and safety of EBUS-TBNA for nodal staging of non-small cell lung cancer (NSCLC). [24][25][26][27][28] Hence, implementation of ultrasound guidance during the sampling procedure, i.e., EBUS-TBNA would yield more reliable results. Also, TBNA has a documented flaw of being highly operator-dependant.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic yield of conventional transbronchial needle aspiration in suspected bronchogenic carcinoma without intraluminal growth on bronchoscopy

2017

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Background: Bronchogenic carcinoma with spread along the mucosal plane presents as an exophytic mass. Most of the submucosal and peribronchial patterns of this malignancy are harder to detect by standard diagnostic procedures such as bronchial washing, brushing and forceps biopsy. We sought to investigate the utility of transbronchial needle aspiration (TBNA) in the diagnosis of bronchogenic carcinoma without intraluminal mass, through prospective analysis of routine diagnostic bronchoscopies performed in a 24-month period, at a tertiary care hospital.Methods: Patients with suspected bronchogenic carcinoma (clinical and radiological) underwent standard computed tomography (CT) of thorax. Further the patients were subjected to conventional TBNA, singly, and in combination with bronchial washings and brushings. The results were analyzed statistically for the diagnostic yield of TBNA.Results: Among the 42 patients assessed, 29 had malignancy confirmed by forceps biopsy or CT guided Fine Needle aspiration cytology or biopsy and bronchoscopy. Among them, 17 cases were detected by a combination of the results of bronchial washing, brushing and TBNA. The individual sensitivities amounted to 3.4% (n=1), 51.72% (n=15) and 27.6% (n=8), respectively. There were no false positive results. Concerning different bronchoscopic sampling techniques, 9 cases were diagnosed solely by bronchial brushings and 2 cases by TBNA alone. No periprocedural complications were encountered.Conclusions: Value of bronchial brushing in the diagnosis of bronchogenic carcinoma without bronchoscopically visible intraluminal mass is above that of conventional TBNA. Addition of bronchial washings, to bronchial brushings and TBNA has an insignificant impact on the diagnosis.

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“…The clinical usefulness of endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) in the diagnosis and staging of lung cancer, sarcoidosis, and other causes of mediastinal and hilar lymphadenopathy has clearly been demonstrated 1, 2, 3, 4, 5. Over the past decade, there has been widespread interest in EBUS among chest physicians; however, the amount of training required to achieve competency of this procedure has not been clearly established.…”

Section: Introductionmentioning

confidence: 99%

Influence of trainee involvement on procedural characteristics for linear endobronchial ultrasound

et al. 2017

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BackgroundLinear endobronchial ultrasound (EBUS) is a safe and effective method for the diagnostic sampling of mediastinal lymph nodes. However, there is a learning curve associated with the procedure and operator experience influences diagnostic yield. We sought to determine if trainee involvement during EBUS influences procedural characteristics, complication rate, and diagnostic yield.MethodsWe performed a retrospective analysis of 220 subjects who underwent an EBUS procedure at our center from December 2012 to June 2013. Procedures were performed by six different interventional pulmonologists with substantial experience with EBUS or by a trainee under their direct supervision. Procedural characteristics and complications were recorded. Diagnostic yield and specimen adequacy were compared between groups.Results EBUS was performed in 220 patients with a trainee involved (n = 116) or by staff physician alone (n = 104). Patient characteristics, and the number and size of lymph node stations sampled were similar. EBUS duration was longer (16.0 vs. 13.7 minutes; P = 0.002) and the total dose of lidocaine used was higher (322.3 vs. 304.2 mg; P = 0.045) when a trainee was involved. The rate of adequate specimens sampled was comparable between the groups (92.0 vs. 92.0%; P = 0.60). Diagnostic yield was lower when a trainee was involved in the EBUS procedure (52.6 vs. 68.3%; P = 0.02).ConclusionTrainee involvement significantly increased EBUS duration and the dose of local anesthesia used for the procedure. Diagnostic yield was lower when a trainee was involved. Factors accounting for this difference in yield, despite adequate samples being obtained, warrant further investigation.

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Effectiveness and safety of endobronchial ultrasound-transbronchial needle aspiration: a systematic review

Cited by 377 publications

References 36 publications

Complications of Convex-Probe Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Multi-Center Retrospective Study

Complications of Convex-Probe Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Multi-Center Retrospective Study

Diagnostic yield of conventional transbronchial needle aspiration in suspected bronchogenic carcinoma without intraluminal growth on bronchoscopy

Influence of trainee involvement on procedural characteristics for linear endobronchial ultrasound

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