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Background:Conventional transbronchial needle aspiration (c-TBNA) is an underutilized bronchoscopic modality. Endobronchial ultrasound (EBUS) guided-TBNA though efficacious is an expensive modality, facilities of which are available at only limited centers. c-TBNA is cost-effective and has potential for wide utilization especially in resource-limited settings. Rapid on-site evaluation (ROSE) improves the yield of c-TBNA.Materials and Methods:A retrospective review of the bronchoscopy records (May 2012 to July 2014) was performed. The patients who underwent c-TBNA with ROSE were included in the study and their clinical details were extracted. Convex probe EBUS-TBNA was being regularly performed during the study period by the operators performing c-TBNA.Results:c-TBNA with ROSE was performed in 41 patients with mean age of 42.4 (16.2) years. The most frequently sampled node stations (>90% patients) were the subcarinal and lower right paratracheal. Representative samples could be obtained in 33 out of the 41 patients (80.4%). c-TBNA was diagnostic in 32 [tuberculosis (TB)-8, sarcoidosis-9, and malignancy-15] patients out of the 41 patients. The overall diagnostic yield (sensitivity) of c-TBNA with ROSE was 78%. Mean procedure duration was 18.4 (3.1) min and there were no procedural complications.Conclusion:c-TBNA with ROSE is a safe, efficacious, and cost-effective bronchoscopic modality. When it was performed by operators routinely performing EBUS-TBNA, diagnostic yields similar to that of EBUS-TBNA can be obtained. Even at the centers where EBUS facilities are available, c-TBNA should be routinely performed.

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Background Endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) and transesophageal bronchoscopic ultrasound‐guided fine‐needle aspiration (EUS‐B‐FNA) are established modalities for evaluation of mediastinal/hilar lymphadenopathy in adults. Limited literature is available on the utility of these modalities in the pediatric population. Herein, we perform a systematic review and meta‐analysis on the yield and safety of EBUS‐TBNA and EUS‐B‐FNA in children. Methods We performed a systematic search of the PubMed and EMBASE databases to extract the studies reporting the utilization of EBUS‐TBNA/EUS‐B‐FNA in children (<18 years of age). The pooled diagnostic yield and sampling adequacy (proportions with 95% confidence intervals [CIs]) were calculated using meta‐analysis of proportions using the random effects model. Details of any procedure‐related complications were noted. Results The search yielded 12 relevant studies (5 case series and 7 case reports on EBUS‐TBNA/EUS‐B‐FNA, 173 patients). Data from five case series (164 patients) were summarized for the calculation of the sampling adequacy and diagnostic yield. Safety outcomes were extracted from all publications. The pooled sampling adequacy and combined diagnostic yield of EBUS TBNA/EUS‐B‐FNA were 98% (95% CI, 92%–100%) and 61% (95% CI, 43%–77%), respectively. A procedure‐related major complication was reported in one patient (1/173, a major complication rate of 0.6%), and minor complications occurred in six patients (6/173, a minor complication rate of 3.5%). Conclusions EBUS‐TBNA and EUS‐B‐FNA are safe modalities for evaluation of mediastinal lymphadenopathy in the pediatric population. EBUS‐TBNA/EUS‐B‐FNA may be considered as the first‐line diagnostic modalities for this indication, as they have a good diagnostic yield and can avoid the need for invasive diagnostic procedures.