Continuing practice is needed to maintain competency in endobronchial ultrasound-guided transbronchial needle aspiration

Abstract

BACKGROUND: It has been accepted that after training, a competent endobronchial ultrasound (EBUS) operator should perform at least twenty procedures per year. However, the literature supporting this subject is scarce. This study focuses on the return performance of an experienced bronchoscopist after a 5-year long break. The aim of this study is to reveal a possible decrease in the diagnostic performance after discontinued practice. MATERIALS AND METHODS: The data of patients who have undergone EBUS-guided transbronchial needle aspiration (EBUS-TBNA) for mediastinal or hilar lesions (lymphadenopathies and masses) between April and September 2016 were reviewed retrospectively. All consecutive patients were involved in the study. All EBUS-TBNA procedures were performed by a single experienced bronchoscopist who have returned after a 5-year long break and restarted to perform EBUS. The patients were divided into two groups: first twenty cases and subsequent eighty cases. The diagnostic performance of EBUS was compared between the two groups. RESULTS: One hundred consecutive patients were included (2.89 lesions per patient) in the study. Demographic and sonographic data were not different between the two groups. In overall, EBUS-TBNA was diagnostic in 281 (97.2%) of 289 lesions. The sensitivity values of EBUS-TBNA in the first and second groups were 92.9% and 98.3%, respectively. The difference was statistically significant (P = 0.048). CONCLUSIONS: This study shows the need for continuing practice in EBUS. An operator should perform at least twenty procedures per year to maintain competency.