TY - JOUR T1 - Assessing the learning curve for EUS(b)-FNA in comparison with classical 'blind' TBNA JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P287 AU - Ilya Sivokozov AU - Olga Lovacheva AU - Irina Shumskaya Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P287.abstract N2 - Background. Transbronchial needle aspiration (TBNA) is a challenge due to very flat learning curve. Now, EUS and EBUS significantly improved the results of TBNA. Nevertheless, number of 'learning' procedures to become an expert in this type of biopsy is controversial.Aim. To evaluate the learning curve for EUS(b)-FNA versus classical 'blind' TBNA in a tertiary center.Materials. Patients with chest lymphadenopathy with main suspicion for sarcoidosis referred to the bronchoscopy were randomized 1:1 to EUS(b)-FNA (arm A) or classical blinded TBNA (Arm B). All procedures performed under local anesthesia by experienced endoscopist with no skills for both techniques, under expert control. Position 7 or 4L were punctured in both groups. Age, sex, size of lymph nodes by CT, number of biopsies, duration of procedure, complications, quality of diagnostic material and diagnostic yield were assessed.Results. 56 patients were enrolled into the study, with 28 for each arm. Patients were comparable in age (mean 44,2 yrs) and sex (men 34/56), and size of target lymph nodes (27±5 mm). There were no complications. Median duration of procedure in arm A reduced from 9 min for first 5 pts to 4 min in last 5 pts (p<0.05), for arm B from 7 to 3 min (p<0.05). Median number of biopsies was equal in both groups - 3. Acceptable biopsy quality (>80%) reached plateau after 15 patients (42 biopsies) in group A and 25 pts (67 punctures) in group B (p<0,05). Diagnostic yield was higher in a group A: 75% versus B: 64,3% (p<0.05).Conclusion. The learning curve of EUS(b)-FNA estimates a number of procedures to achieve an acceptable level of performance in 15 procedures, whereas classical TBNA needs 10 procedures more. ER -