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Randomized controlled trial to evaluate the utility of suction and inner-stylet of EBUS-TBNA for mediastinal and hilar lymphadenopathy
- Source :
- BMC Pulmonary Medicine, Vol 18, Iss 1, Pp 1-7 (2018), BMC Pulmonary Medicine
- Publication Year :
- 2018
- Publisher :
- Springer Science and Business Media LLC, 2018.
-
Abstract
- Background The optimal procedure for maximizing the diagnostic yield and minimizing the procedural complexity of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is controversial. We conducted a prospective randomized controlled trial to determine the optimal procedure of EBUS-TBNA for mediastinal and hilar lymphadenopathy, with a particular focus on the roles of the inner-stylet and suction. Methods Consecutive patients with enlarged mediastinal and hilar lymph nodes (LNs), detected by computed tomography (CT) or positron emission tomography-CT (PET-CT), who underwent EBUS-TBNA were included. Each LN was sampled with three needle passes using suction–stylet, suction–no stylet, and stylet–no suction procedures. The samples were smeared onto glass slides for cytological evaluation. A single, blinded cytopathologist evaluated each set of slides. The primary outcomes were cytological specimen adequacy rate and diagnostic yield of malignant LNs. The secondary outcomes were tissue-core acquisition rate, procedural time, and the amount of bleeding. Results This study evaluated 97 patients with a total of 255 LNs. The final LN diagnosis was benign in 144, malignant in 104, and inadequate in 7 cases. There were no significant differences among the suction–stylet, suction–no stylet, and stylet–no suction groups in specimen adequacy rate (87.1, 88.2, 85.9%, respectively) or diagnostic yield of malignancy (32.2, 31.8, 31.0%, respectively). However, the use of suction was associated with an increase in tissue-core acquisition rate (P
- Subjects :
- Male
Pulmonary and Respiratory Medicine
Ebus tbna
Suction (medicine)
medicine.medical_specialty
Lymphadenopathy
Malignancy
Specimen Handling
law.invention
Endobronchial ultrasound-guided transbronchial needle aspiration
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
Hilar lymph nodes
law
Neoplasms
Positron Emission Tomography Computed Tomography
Humans
Medicine
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Aged
Neoplasm Staging
lcsh:RC705-779
Malignant
business.industry
Mediastinum
Hilar lymphadenopathy
lcsh:Diseases of the respiratory system
Middle Aged
medicine.disease
Stylet
Clinical trial
Treatment Outcome
030228 respiratory system
Dimensional Measurement Accuracy
030220 oncology & carcinogenesis
Female
Lymph Nodes
Radiology
Tomography, X-Ray Computed
business
Research Article
Subjects
Details
- ISSN :
- 14712466 and 17010616
- Volume :
- 18
- Database :
- OpenAIRE
- Journal :
- BMC Pulmonary Medicine
- Accession number :
- edsair.doi.dedup.....0c3ffde27c16893c0c164782914bdd31