Chest
BronchoscopyUltrasound-Guided Transbronchial Needle Aspiration*: An Experience in 242 Patients
Section snippets
Patients
Between January 1999 and January 2000, all patients referred for diagnostic TBNA of mediastinal lymph nodes were included into this prospective study. Bronchoscopy was performed in standard fashion either under general anesthesia for combined rigid and flexible examinations or conscious sedation for flexible endoscopy. TBNA and EBUS were performed as detailed below. Indications for TBNA, lesion size on chest CT, number of passes, diagnosis, and complications were recorded. EBUS and TBNA were
Results
Two hundred forty-two patients underwent TBNA; 82 patients were women and 160 were men (mean age, 60.0 years; SD, 11.8; range, 33 to 76 years). Target lymph nodes are listed in Table 1. The mean lymph node size was 1.7 cm (SD, 0.47; range, 0.8 to 4.3 cm). The main indications for TBNA were for diagnosis of enlarged lymph nodes with unknown origin and cancer staging, especially exclusion of N3 nodes.
In 207 patients (86%), the lymph nodes were accessed successfully by TBNA (specific diagnosis or
Discussion
TBNA is a well-established bronchoscopic technique but remains underutilized and the yield varies widely. This fact may be due to the long learning curve and its associated frustrations. Additionally, conventional TBNA is a fairly blind technique preventing target visualization. This makes accessing smaller lymph nodes and nodes in some locations more difficult.
Imaging of the target during the procedure has received increased attention recently, and studies have found the use of CT fluoroscopy
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