Chest
Original ResearchInterventional PulmonologyA Randomized Controlled Trial of Standard vs Endobronchial Ultrasonography-Guided Transbronchial Needle Aspiration in Patients With Suspected Sarcoidosis
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Study Design
This single-center study employed a randomized controlled design, with blinded analysis of the cytopathologic samples. The protocol was approved by the Conjoint Health Research Ethics Board of the University of Calgary, and written informed consent was obtained from all patients.
Patients were eligible for this study if they were ≥ 16 years of age, had pathologic mediastinal or hilar adenopathy (short axis, > 1 cm) confirmed on CT scan of the chest, were considered to have a likely diagnosis of
Results
Sixty-one patients were screened and 50 were randomized (Fig 1) between September 2006 and August 2007. Chart review was completed between June 2008 and August 2008. Baseline characteristics can be found in Table 1. All patients underwent mediastinal lymph node aspiration according to their assigned randomization group. Bronchoscopy was performed by interventional pulmonary medicine fellows assisted by a dedicated interventional pulmonary medicine physician in 48 of the 50 cases, with 2 cases
Discussion
EBUS is rapidly changing the assessment of the mediastinum, especially in patients with suspected lung malignancies in whom diagnostic yields and sensitivities of > 90% have been achieved.12, 13, 15, 20, 21 Interestingly, there has yet to be a randomized controlled study comparing linear EBUS-guided TBNA with standard TBNA in any patient population, although one randomized study27 did show the superiority of balloon probe radial, EBUS-guided TBNA vs standard TBNA.
In patients with suspected
Acknowledgments
Author contributions: All authors were involved with the acquisition, analysis, and interpretation of data. Drs. Tremblay, Stather, and Field were involved with the conception and design. Dr. Tremblay was involved with the drafting of the manuscript, statistical analysis, obtaining funding, and supervision of the study. Drs. Stather, MacEachern, Khalil, and Field were involved with the critical revision of the manuscript.
Financial/nonfinancial disclosures: The authors have reported to the ACCP
References (0)
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Funding/Support: The University of Calgary has received unrestricted educational grant support from Olympus Canada for support of continuing medical education courses on endobronchial ultrasonography, as well as for support of the interventional pulmonary medicine training program. Funding was received from the Jack Mackenzie Memorial Fund.
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