Endobronchial Ultrasound guided Transbronchial Needle Aspiration (EBUS-TBNA) is a relatively new technique for diagnosing mediastinal/lung masses. It is not widely available in rural community hospitals. The purpose of this abstract is to evaluate the safety and diagnostic yield of EBUS-TBNA at one rural community hospital.
In a small rural community hospital, the EBUS-TBNA procedure data from its inception (April 2007) upto April 2009 was retrospectively analyzed. All procedures were performed by the same provider. Both the preoperative and postoperative diagnoses were obtained for each procedure. Rapid on-site Cytologic examination (ROSE) was available for all procedures. Pathologists reporting the presence of adequate specimen was considered as positive diagnostic yield. Documentation of post operative complications were also evaluated.
A total of 80 EBUS procedures, (34 for mediastinal adenopathy and 46 for hilar mass), were performed. EBUS-TBNA was done in 66 cases. In 14 cases EBUS-TBNA was not performed because of presence of endobronchial lesion, intervening vascular structure and the lymph node was less than 1 cm. Out of 66 cases of EBUS-TBNA, 57(86.4%) had positive diagnostic yield and 9(13.6%) were reported as non-diagnostic specimen. The distribution of positive cases is as follows, 28(42.4%) were Non-Small cell lung cancer, 18 (27.3%) were Small cell lung cancer, 8 cases were negative for malignant cells, 2 were lymphoma and 1 was Sarcoidosis. There was no report of complication in any of those procedures.
In a small rural community hospital setting, EBUS-TBNA has a high diagnostic yield and a relatively safe procedure. This is of particular importance for Pulmonologist in rural areas where thoracic surgery and endoscopic gastrointestinal ultrasound resources are limited.
EBUS-TBNA is a relatively safe procedure and provides an excellent tool for Pulmonologist in a small rural community hospital. Avoiding costly, inconvenient referrals and transfers to tertiary centers could greatly improve patient satisfaction and compliance if EBUS-TBNA becomes more commonplace in these smaller hospitals.
Matthew Higgins, No Financial Disclosure Information; No Product/Research Disclosure Information