Relevance of Training in Transbronchial Fine-Needle Aspiration Technique

Castro, Felipè Rodríguez de; López, Fernando Díaz; Serdà, Gabriel Julià; Navarro, Pedro Cabrera; López, Agustín Rey; Gilart, Jordi Freixinet

doi:10.1378/chest.111.1.103

Cited by 67 publications

(24 citation statements)

References 9 publications

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“…HAPONIK and STURE [22] demonstrated that the diagnostic yield on TBNA performed by 14 bronchoscopists increased from 21.4 to 47.6% during a 3-yr period of training and of educational intervention. DE CASTRO et al [34] reported that the diagnostic yield of an expert bronchoscopist was 77%, while the yield of a pulmonologist without specific experience on TBNA was 23.5%. This value rose to 78% after a training of 24 months.…”

Section: Resultsmentioning

confidence: 99%

Transbronchial and transoesophageal (ultrasound-guided) needle aspirations for the analysis of mediastinal lesions

Herth

Rabe²,

Gasparini³

et al. 2006

Eur Respir J

138

103

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A tissue diagnosis of mediastinal nodes is frequently needed for accurate lung cancer staging as well as the assessment of mediastinal masses. Transbronchial needle aspiration (TBNA) is a safe procedure that is performed during routine bronchoscopy. Provided mediastinal metastases are confirmed, TBNA has a high impact on patient management. Unfortunately, TBNA remains underused in current daily practice, mainly due to the lack of realtime needle visualisation. The introduction of echo-endoscopes has overcome this problem.Endobronchial ultrasound-guided TBNA (EBUS-TBNA) allows real-time controlled tissue sampling of paratracheal, subcarinal and hilar lymph nodes. Mediastinal lymph nodes located adjacent to the oesophagus can be assessed by transoesophageal ultrasound-guided fine needle aspiration (EUS-FNA). Owing to the complementary reach of EBUS-TBNA and EUS-FNA in assessing different regions of the mediastinum, recent studies suggest that complete and accurate mediastinal staging can be achieved by the combination of both procedures.It is expected that implementation of minimally invasive endoscopic methods of endobronchial ultrasound-guided transbronchial needle aspiration and transoesophageal ultrasound-guided fine needle aspiration will reduce the need for surgical staging of lung cancer significantly.

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Section: Resultsmentioning

confidence: 99%

Transbronchial and transoesophageal (ultrasound-guided) needle aspirations for the analysis of mediastinal lesions

Herth

Rabe²,

Gasparini³

et al. 2006

Eur Respir J

138

103

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“…Hence, better technical expertise may increase the diagnostic yield of this conventional procedure. 29 Also, incorporation of rapid on-site evaluation (ROSE) of the samples harvested, by a cytopathologist, would increase yield by a significant figure. 30 The utility of TBNA in the detection and staging of lung carcinoma has been studied extensively, and the technique has been proved favourable for the purpose.…”

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 ultimate diagnostic success depends on the pathologic etiology of the lymphadenopathy [3, 14, 15], the size of the enlarged lymph nodes [3, 14, 15] and their location [3, 12, 14], the experience of the bronchoscopist [16], the number of needle samples obtained [17], other ancillary techniques used (ultrasound or CT fluoroscopy) [18, 19], onsite analysis of needle aspirate [20], bronchoscopic findings (widening of the carina, erythema or visible tumor) [14, 15, 21], and the model and type of the needle used [2, 6,22,23,24]. …”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of the eXcelon Transbronchial Aspiration Needle in Mediastinal Lymph Node Enlargement: A Case-Control Study

Fernández-Villar¹,

Leiro²,

Blanco³

et al. 2006

Respiration

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Background: Several different types of needles for transbronchial needle aspiration (TBNA) exist in the market. Recently, the eXcelon transbronchial needle (Boston Scientific, Boston, Mass., USA) was commercialized, and to our knowledge, no comparative studies with other types of needles have been performed up to date. Objectives: The aim of the present study was to determine the diagnostic yield and safety of the 21-gauge eXcelon transbronchial needle in the diagnosis of mediastinal lesions and to compare it with a 22-gauge Wang cytology needle (Bard-Wang, Billerica, Mass., USA). Methods: A case-control prospective study was conducted. The study group included 42 TBNA of mediastinal nodes performed in 35 patients with the eXcelon 21-gauge needle from January to June 2005. A control group included 110 TBNA carried out in 99 patients that underwent mediastinal lymph node sampling using a MW-122 needle from June 2002 to December 2004. Results: There was no statistical differentiation in the characteristics of the disease, mediastinal lymph nodes or number of passes between cases and controls. Adequate samples were obtained in 30 (71.4%) cases and 81 (73.6%) controls (p = 0.8). Technical complications occurred in 7 (16.6%) cases and 14 (12.7%) controls (p = 0.7). The only clinical complication was bleeding presented in 2 (4.8%) cases and 3 (2.7%) controls (p = 0.3). Conclusion: The eXcelon 21-gauge transbronchial needle is as effective and safe as the MW-122 needle in the diagnosis of mediastinal lymph node enlargement.

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Relevance of Training in Transbronchial Fine-Needle Aspiration Technique

Cited by 67 publications

References 9 publications

Transbronchial and transoesophageal (ultrasound-guided) needle aspirations for the analysis of mediastinal lesions

Transbronchial and transoesophageal (ultrasound-guided) needle aspirations for the analysis of mediastinal lesions

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

Efficacy and Safety of the eXcelon Transbronchial Aspiration Needle in Mediastinal Lymph Node Enlargement: A Case-Control Study

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