PT - JOURNAL ARTICLE AU - Isabelle Fresard AU - Gregoire Gex AU - Marianne Gex-Fabry AU - Paola M. Soccal TI - Impact of multiple operators on diagnostic yield of EBUS-TBNA DP - 2012 Sep 01 TA - European Respiratory Journal PG - P285 VI - 40 IP - Suppl 56 4099 - http://erj.ersjournals.com/content/40/Suppl_56/P285.short 4100 - http://erj.ersjournals.com/content/40/Suppl_56/P285.full SO - Eur Respir J2012 Sep 01; 40 AB - BackgroundEBUS-TBNA is usually performed by a limited number of operators in each institution in order to achieve optimal yield by accumulating individual expertise. We aimed to assess the diagnostic performance and safety of EBUS-TBNA when this procedure is learned by every trainee.MethodsAll consecutive patients undergoing EBUS-TBNA were prospectively included since the introduction of EBUS in our institution in January 2008 until December 2011. Each procedure was done by 2 or 3 operators including 1 senior supervisor. Rapid on-site cytologic evaluation (ROSE) was performed since June 2011. Predicting factors for the diagnostic accuracy of EBUS-TBNA were analyzed per patient and per sampled lymph node.Results15 operators performed EBUS-TBNA in 160 patients. Definitive diagnosis was available for 156 patients (mean age 59.4±14.6 years, 38.5% F). Lymph nodes were malignant in 53.2%. Overall diagnostic accuracy was 82.7% (95% CI 76.4–88.2) and 90.3% (95% CI 81.9–97.2) for NSCLC and SCLC (n=72). Overall diagnostic accuracy tended to increase over years: 70.6%, 81.8%, 82.9% and 85.9% in 2008, 2009, 2010 and 2011 respectively (p=0.51). Subgroup analysis showed no significant influence of ROSE, number of sampled nodes per case, localization and size of lymph node and SUV max. Complications were restricted to 3 minor endobronchial bleeding.ConclusionsAt Geneva University Hospitals, EBUS-TBNA performance increased over years following well-known learning curves. Yet, in our setting, EBUS- learning curve seemed rather center-than operator-related. Providing on site direct supervision by a senior-experienced operator, EBUS is indeed constantly performed by junior operators without affecting the performance of the method.