Diagnostic Performance/Learning Curve and Tolerance of Endobronchial Ultrasound (EBUS)

Abstract

OBJECTIVES :To analyze the diagnostic performance of transbronchial needle aspiration guided by endobronchial ultrasound(EBUS-TBNA) in diagnosing hilar/mediastinal lymphadenopathies and/or lung masses in our department and the possible effects of the learning curve.To evaluate the tolerance of the procedure by both the patient and the doctor and its complications. MATERIALS AND METHODS: Retrospective study of all patients referred to our department(January2010-October2011)to perform EBUS-TBNA.At the end of the technique, both the patients and bronchoscopist answered a tolerance questionnaire(scale of 0 to7). RESULTS :n=129 patients. 325 aspirations were performed.The most common indication was suspicion of malignancy(48.8%).The most frequent final diagnosis was normal lymph nodes(46.5%),followed by neoplasm(35.6%).The sensitivity(S)and negative predictive value(NPV)for the final diagnosis of malignancy was 93,4% and 95.5%,respectively.In order to analyze learning curve effects,we study the first 25 cases and the remainder,separately,with the S and NPV of 83.3% and 94.1%,respectively,without statistically significant differences.In 63.56%,the tolerance of the technique was 5.18 ± 2.12vs4.62 ± 2.41(patient vs.bronchoscopist).With regard to complications,90.7% did not register any complication. CONCLUSIONS :EBUS-TBNA is a diagnostic tool with a high profitability in the study of hilar/mediastinal lymphadenopaties which was higher in neoplastic lymphadenopathy.In our case,there were no statistically significant differences regarding the diagnostic performance of the technique during the learning curve. EBUS-TBNA is a safe and well-tolerated method by both the patient and the endoscopist.