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Pulmonology Procedures |

Transbronchial Needle Aspiration: A Tool for a Community Bronchoscopist

Elif Küpeli*, MD; Ruhsel Corut, MD; Leyla Memis, MD; Fusun Eyüboglu, MD
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Baskent University School of Medicine, Pulmonary Diseases Department, Ankara, Turkey


Chest. 2012;142(4_MeetingAbstracts):904A. doi:10.1378/chest.1389524
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Abstract

SESSION TYPE: Diagnostic Bronchoscopy

PRESENTED ON: Tuesday, October 23, 2012 at 04:30 PM - 05:45 PM

PURPOSE: Conventional transbronchial needle aspiration (C-TBNA) has been proven to be a safe, minimally invasive, and cost-effective technique in establishing diagnosis of mediastinal pathologies. We studied the success of C-TBNA in our community practice, in patients with mediastinal lymphadenopaties.

METHODS: Technique of C-TBNA was learned solely from the literature, videos and practicing on inanimate models at “Hands-On” courses. Conventional TBNA with 21and/or 19 gauge Smooth Shot Needles was performed on consecutive patients with undiagnosed mediastinal lymphadenopathy

RESULTS: Fifty-four patients (Male 38), mean age 56.9 ± 11.8 years underwent C-TBNA. Thirty-three patients had nodes larger than 20 mms. Final diagnoses were malignancy 29, sarcoidosis 9, reactive lymph nodes 15 and tuberculosis 1. Final diagnosis was established by C-TBNA in 27. The exclusive diagnostic yield of TBNA was 42.5% (n: 23). Nodal size had an impact on outcome (p=0.002) while location didn’t (p=0.82). C-TBNA was positive in 22/34 when malignancy was suspected (yield 64.7%), while 5/20 when benign diagnoses were also included in the differential (yield 25%) (p = 0.005). Sensitivity, specificity, PPV, NPV and diagnostic accuracy were 79.4%, 100%, 100%, 73% and 81.5% respectively.

CONCLUSIONS: C-TBNA can be successfully learned without formal training and could be easily applied in the community practice.

CLINICAL IMPLICATIONS: Conventional transbronchial needle aspiration (C-TBNA) has been proven to be a safe, minimally invasive, and cost-effective technique in establishing diagnosis of mediastinal pathologies. Despite its established advantages it still remains as an underutilized and underemphasized in the fellowship training programs. We believe that the procedure of C-TBNA is simple enough that it could be learned outside the IP fellowship program relying on the secondary measures. C-TBNA augments the welfare of patients with suspected lung cancer.

DISCLOSURE: The following authors have nothing to disclose: Elif Küpeli, Ruhsel Corut, Leyla Memis, Fusun Eyüboglu

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Baskent University School of Medicine, Pulmonary Diseases Department, Ankara, Turkey

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