ANALYSIS OF THE FIRST 100 CASES OF ENDOBRONCHIAL ULTRASOUND-GUIDED TRANSBRONCHIAL NEEDLE ASPIRATION AT A TERTIARY CARE HOSPITAL IN SAUDI ARABIA

Abstract

SESSION TITLE: Tuesday Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/22/2019 01:00 PM - 02:00 PM PURPOSE: Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) has been recommended in obtaining a cytological and histological diagnosis for patients with mediastinal and hilar lymphadenopathy for suspected lung cancer, sarcoidosis, and tuberculosis. The purpose of this study is to describe EBUS-TBNA results for the first one hundred patients at KFMC in Riyadh, Saudi Arabia. ‏ METHODS: EBUS-TBNA data for the first 105 patients who were referred to pulmonary service in KFMC with mediastinal and hilar lymphadenopathy. The data were collected retrospectively from June 2015 until February 2019. All patients had chest tomography before the procedure. Only five patients were excluded either due to an inaccessible intrathoracic lesion, malfunctioning scope or lack of rapid on-site evaluation. RESULTS: A total of 190 lymph nodes samples were obtained from 100 patients. The mean duration for the procedure was (52.4 ± 23.9) minutes. The mean biopsied lymph node diameter was (19.0 ± 10.3) millimeters. Sub-carinal lymph node station was the most common site of puncture (36.3%) followed by lower paratracheal stations with (33.2%), and interlobular stations with (14.7%). The mean age of the patients was (54.6 ± 14.7) years, with a predominance of males (66%). Only one complication of minor bleeding occurred during the procedure that did not require any further intervention. Majority of patients had the procedure done with conscious sedation (62%). A total of 89 patients (89%) had an adequate sample for cytology, and histopathological evaluation and three patients (3%) required further bronchoscopic intervention due to inadequate sample. We referred the remaining eight patients (8%) for further surgical or radiological intervention. A total of 49 patients (49%) were diagnosed malignancy with histopathology. Adenocarcinoma was the most common malignancy (20%) followed by squamous cell carcinoma (10%), and small lung cancer (8%). Sarcoidosis was found in 6 patients (6%), and two patients (2%) were diagnosed with tuberculosis. CONCLUSIONS: EBUS-TBNA is a useful modality in facilitating a rapid diagnosis with high diagnostic yield for hilar and mediastinal lymphadenopathy in KFMC. We were able to use it more under conscious sedation with no significant complications and low demand for further surgical intervention. CLINICAL IMPLICATIONS: Based on our results, EBUS-TBNA can be used safely as a first diagnostic procedure for hilar and mediastinal lymphadenopathy at our center. DISCLOSURES: No relevant relationships by Khalid Alokla, source=Web Response No relevant relationships by Norah Khalid Shafi, source=Web Response