Ultrasound-guided Transbronchial Needle Research Articles

REAL TIME VISUALIZATION OF MEDIASTINAL LYMPH NODES WHILE DOING ENDOBRONCHIALULTRASOUND GUIDED TRANS BRONCHIAL NEEDLE ASPIRATION (EBUS-TBNA) USING CONVEX PROBE GIVES BETTER DIAGNOSTIC YIELD THAN CONVENTIONAL TBNA AND MEDIASTINOSCOPY:

Introduction:Real time visualisation of mediastinal lymph nodes makes it easy to Hit & Run with convex probe while doing Endobronchial Ultrasound guided Trans Bronchial Needle Aspiration (CP-EBUS-TBNA) whichgives better safety profile, diagnostic yield and is gradually replacingConventional Trans Bronchial Needle Aspiration( C-TBNA) and Mediastinoscopy. We analysed retrospectively the diagnostic yield of EBUS-TBNA done at Asian Institute of Medical Sciences, a tertiary hospital at Faridabad in Haryana. Materials and Methods: We pulled in the dataof EBUS-TBNA done on patients with Mediastinal lymphadenopathy short axis nodal diameter >0.5 cm, on computed tomography of thorax from Nov 2016 to May 2019. The procedures were done under conscious sedation by multiple operators who had done 20 EBUS-TBNA independently. A sample that was positive for AFB smears/malignant cells or granuloma was considered to be diagnostic. Results: The study included 250 patients (156 males) with mean age 49.6 years. EBUS-TBNA detected 427enlarged mediastinal nodes with average diameter of 14.45±8.56 mm. A total of 376 lesions were sampled of which subcarinal lymph node was the most common station (86.4%) followed by Pre & Paratracheal (11.6 %). Average of 1.5 lymph nodes was sampled per patient with 3 passes per lymph node. The procedure had a diagnostic yield of 86 %. Majority of the patients were diagnosed with Granulomatous pathology (44.8 %): Sarcoidosis (24 %)followed by Tuberculosis (20 %). Malignancy was diagnosed in 12 % of patients of which non small cell cancer constituted the major diagnosis(50%). No complication was observed. Conclusion: EBUS- TBNA is very safe procedure with consistent good diagnostic yieldwith multiple operators beyond learning curves than for C- TBNA which require extensive training and expertise of the operator besides size and location of the lesion, though the availability due tohigher costs limits its usage.

Anaesthetic management of endobronchial ultrasound guided trans bronchial needle aspiration: Our experience with laryngeal mask airway

Introduction: Endobronchial Ultrasound Guided Trans bronchial needle aspiration (EBUS-TBNA) is a minimally invasive diagnostic modality for evaluating intra thoracic lymph nodes, becoming one of the important tool in the armamentarium of pulmonologists. The size of the fiberscope and sharing of the airway with the bronchoscopist poses unique challenges to the anesthesiologist. In light of these developments it is important to develop an office based anesthesia technique for this relatively new procedure. Hence we did this descriptive cohort study. Aim: To describe the accuracy and anaesthetic management of EBUS-TBNA as a day care procedure, done with general anesthesia (GA). Materials and Methods: Data was collected from January 2017 to December 2017 at our institute from patients who underwent EBUS-TBNA under GA using second generation laryngeal mask airway (LMA). Specifically, hemodynamic status, Oxygen saturation, duration of the procedure, diagnostic yield and complications of the procedure were recorded. Results: 23 patients underwent EBUS-TBNA under GA. All patients were found to be hemodynamically stable with fluctuations in blood pressure and heart rate being less than 20% from the baseline with no episodes of desaturation .The average number of biopsies taken is 3.3, with average duration of the procedure being 67.0±17.6 (mean±SD) minutes. The incidence of post procedural complications like cough and sore throat were minimal. Successful diagnostic yield was found in all cases with no incidence of recall of the procedure. Conclusion: The performance of EBUS-TBNA under general anesthesia with LMA provides great hemodynamic stability and adequate ventilation in a shared airway. It demonstrates excellent diagnostic accuracy. It provides comfort to the patient and the good examination conditions to the bronchoscopist. Clinical Significance: Use of P-LMA solves the dilemma of managing ventilation during EBUS TBNA without affecting the diagnostic yield of the pr

Endobronchial ultrasound- guided transbronchial needle aspiration for mediastinal lymph node staging in patients with typical pulmonary carcinoids

BackgroundPulmonary carcinoids, which are well-differentiated lung neuroendocrine carcinomas, account for only 1–2 % of primary lung malignancies. Although fluorodeoxyglucose positron-emission tomography/computed tomography performs poorly in the identification of mediastinal lymph node metastases, particularly for pulmonary carcinoids, endobronchial ultrasound-guided (EBUS) transbronchial needle aspiration (TBNA) may be a useful means of preoperative nodal assessment in patients with these conditions. However, the diagnostic performance of EBUS TBNA is unknown. This study was designed to determine the sensitivity of EBUS for mediastinal staging in patients with typical carcinoid. Study design and methodsA retrospective review of all patients with carcinoids who underwent EBUS TBNA and/or surgical resection with lymphadenectomy at The University of Texas MD Anderson Cancer Center was performed. The sensitivity of EBUS –TBNA in diagnosis of mediastinal lymph node metastases was determined. ResultsOf the 212 patients with pulmonary carcinoids we identified, 137 had surgery with no preoperative EBUS TBNA, 68 had EBUS TBNA followed by surgery, and 7 had EBUS TBNA only. The sensitivity rate for EBUS TBNA in diagnosis of mediastinal lymph node metastases was 77.78 % overall (95 % CI, 57.7−91.3%) and it was 87.5 % (95 % CI, 67.6−97.3%) when we considered only patients with EBUS TBNA-accessible lymph nodes. DiscussionThe sensitivity of EBUS TBNA for diagnosis of mediastinal lymph node metastases of pulmonary carcinoids was slightly lower than that reported previously for non-small cell lung cancer. Preoperative EBUS TBNA identified nodal metastases not previously identified by imaging.

The Initial Impact of Implementing Rapid On-Site Evaluation of Endobronchial Ultrasound-Guided Transbronchial Fine Needle Aspirations in a University Setting

The Initial Impact of Implementing Rapid On-Site Evaluation of Endobronchial Ultrasound-Guided Transbronchial Fine Needle Aspirations in a University Setting

Biopsy Site Changes in Resected Mediastinal Lymph Nodes with Prior Endobronchial Ultrasound-Guided Transbronchial Fine Needle Aspiration (EBUS-TBNA)

Biopsy Site Changes in Resected Mediastinal Lymph Nodes with Prior Endobronchial Ultrasound-Guided Transbronchial Fine Needle Aspiration (EBUS-TBNA)

2012年アンケート調査からみた日本におけるendobronchial ultrasound-guided transbronchial needle aspirationの実態

2012年アンケート調査からみた日本におけるendobronchial ultrasound-guided transbronchial needle aspirationの実態

Use of Dynamic Telecytopathology for Rapid On-Site Evaluation of Endobronchial Ultrasound-Guided Transbronchial Fine Needle Aspiration Biopsies

Use of Dynamic Telecytopathology for Rapid On-Site Evaluation of Endobronchial Ultrasound-Guided Transbronchial Fine Needle Aspiration Biopsies