A comparative study on the value of conventional vs.radial probe endobronchial ultrasound guided transbronchial needle aspiration in the diagnosis of mediastinal and hilar lymphadenopathies

Abstract

Objective To compare the value of conventional vs. radial probe endobronchial ultrasound guided transbronchial needle aspiration in the diagnosis of mediastinal and hilar lymphadenopathies.Methods From January lst, 2009 to June 30th, 2011, 60 patients with 65 enlarged mediastinal and hilar lymph node were ramdomized into conventional TBNA group ( n=30 ) or RPEBUS-TBNA group ( n=32 ), and then subdividede into group one ( subcarinal lymph node ) and group two ( non-subcarinal lymph node ). Compare the differences of positive yield and side effects between the two groups. Results The overall diagnostic yield of conventional TBNA was 36.4％ ( 12/33 ), and RPEBUS-TBNA was 71.9％ ( 23/32 ), P=0.004. In group one ( subcarinal lymph node ), the yield of conventional TBNA was 72.7％ ( 8/11 ),while RPEBUS-TBNA had a yield of 76.9( 10/13 ),but there was no statistically significant differences (P= 0.813 ). In group two ( non-subcarinal lymph node ), the diagnostic yield of conventional TBNA and RPEBUS-TBNA were 33.3％ ( 4/14 ) and 76.5％ ( 13/17 ) respectively,P=0.007. Complications included minimal hemorrhage, cough, transient hypoxemia, all were selflimited. Conclusion RPEBUS-TBNA can improve the diagnostic efficiency than conventional TBNA,especially in the non-subcarinal lymph node station. This technique is minimal invasive, cost-effective,safe and feasible. Key words: Transbronchial needle aspiration ( TBNA ); Radial Probe ( RP ); Endobronchial Ultrasound ( EBUS