A Randomized Comparison of Sample Adequacy and Diagnostic Yield of Various Suction Pressures in EBUS-TBNA

Iyer, Hariharan; Madan, Karan; Hadda, Vijay; Mittal, Saurabh; Tiwari, Pawan; Jain, Deepali; Pandey, Ravindra Mohan; Garg, Avneet; Guleria, Randeep

doi:10.5603/arm.a2021.0054

Cited by 6 publications

(2 citation statements)

References 22 publications

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“…Multiple EBUS-TBNA needles with different gauges (19, 21, 22, and 25), [11][12][13][14][15][16][17] different metal materials, [18] and different shapes [19,20] have been fabricated. The presence or absence of suction pressure, [21][22][23] a combination of rapid cytopathology, [24,25] and the difference of the number of the needle passes [7,26] has also been studied. However, it cannot be said that either the EBUS-TBNA puncture needles, the presence or absence of suction pressure, or what number of needle passes are superior.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the harvest volume between maneuvers of endobronchial ultrasound-guided transbronchial needle aspiration including the “cross-fanning technique”

et al. 2023

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Recently, a certain volume of biopsy specimens has been required for genetic testing of tumors using endobronchial ultrasoundguided transbronchial needle aspiration (EBUS-TBNA). This study aimed to verify the superiority of our newly devised EBUS-TBNA biopsy technique, the "cross-fanning technique," which combines rotation and up-down maneuvers, by comparing its harvest volume with that of other maneuvers. Using a bronchoscope simulator, ultrasonic bronchoscope, and 21-gauge puncture needle, we compared the weight of silicone biopsy specimens obtained by the following 4 procedures: Conventional maneuver; Up-down maneuver; Rotation maneuver, and; Cross-fanning technique. Each procedure was repeated 24 times in total, rotating the sequences of the maneuvers, and the operator/assistant pair to align the conditions. The means ± standard deviations of the sample volumes for each puncture technique were as follows: 2.8 ± 1.2 mg; 3.1 ± 1.6 mg; 3.7 ± 1.2 mg, and; 3.9 ± 1.2 mg. There was a significant difference between the 4 groups (P = .024). The post hoc test showed a statistically significant difference between techniques A and D (P = .019). This study showed that the cross-fanning technique might contribute to the increased volume of tissue samples obtained by EBUS-TBNA biopsy.

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Section: Discussionmentioning

confidence: 99%

Comparison of the harvest volume between maneuvers of endobronchial ultrasound-guided transbronchial needle aspiration including the “cross-fanning technique”

et al. 2023

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“…On the contrary, findings from a recent RCT indicate that no suction may be superior to 20 ml suction for obtaining adequate samples. [ 33 ] ROSE use was common; however, available evidence does not indicate specific benefits with the use of ROSE on diagnostic yield during EBUS-TBNA. [ 34 ] More research is required regarding the utility of ROSE in EBUS-TBNA as benefit has been observed with few endpoints like requirement of additional procedures or number of needle passes.…”

Section: Discussionmentioning

confidence: 99%

A Survey of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA) practices in India

et al. 2022

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Background: There is a lack of data on the prevalent practices of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in India. Aim: To study the current practices of EBUS-TBNA in India. Methods: This survey was an online questionnaire designed on the Google forms interface. The survey included various questions related to demographics, sedation, analgesia and anesthesia, technical aspects, and infection control related to the procedure of EBUS-TBNA. Results: Data from 134 respondents (mean age: 42.2 years) were analyzed. Most (97.8%) were pulmonologists or physicians, and a majority (94.8%) practicing in either a private multi-specialty setting or medical college. 40.3% had received procedure training at a formal training program. Mild/moderate sedation was the most common strategy (70.1%). Midazolam (76.7%), Fentanyl (76.0%), followed by propofol (46.5%), were the most frequent drugs, and 82.8% preferred combination sedation. 26.1% used cricothyroid lignocaine injection, and the use of 1% or 2% lignocaine for spray-as-you-go administration was similar. The oral route was preferred, while the laryngeal mask airway was the most common airway conduit under general anesthesia. Suspected granulomatous mediastinal lymphadenopathy (TB/sarcoidosis) (67.2%), followed by lung cancer (32.8%), were the most common indications of EBUS-TBNA. 81.3% performed EBUS-TBNA for lung cancer staging. 21 G needle was preferred (64.9%), and vacuum suction was common (80.6%). 55.2% routinely performed ROSE. Alcohol fixed glass slide smears were the most common method (93.1%) for cytological preparation. 49.3% also performed EUS-B-FNA. 76.9% routinely obtained endo bronchial biopsy and transbronchial lung biopsy in patients with suspected sarcoidosis. Elastography was infrequently used. Nearly three-fourths (77.6%) reused EBUS needles. Conclusion: There is practice variability in the multiple aspects related technical performance of EBUS-TBNA. Evidence-based guidelines addressing the multiple technical aspects are required to standardize the practice of EBUS-TBNA.

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Endobronchial Ultrasound Staging for Lung Cancer: What We Know Now and What We Need to Know

Bennji,

Sagar,

Jarnagin

et al. 2023

Curr Pulmonol Rep

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A Randomized Comparison of Sample Adequacy and Diagnostic Yield of Various Suction Pressures in EBUS-TBNA

Cited by 6 publications

References 22 publications

Comparison of the harvest volume between maneuvers of endobronchial ultrasound-guided transbronchial needle aspiration including the “cross-fanning technique”

Comparison of the harvest volume between maneuvers of endobronchial ultrasound-guided transbronchial needle aspiration including the “cross-fanning technique”

A Survey of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA) practices in India

Endobronchial Ultrasound Staging for Lung Cancer: What We Know Now and What We Need to Know

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