Modified Technique for Obtaining Mediastinal Samples With Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: Results From a Prospective Observational Study

Rodríguez, Fredy; Seijó, Luis; Sánchez, Pablo A.; Zulueta, Javier

doi:10.1016/j.arbr.2012.10.004

Cited by 6 publications

(3 citation statements)

References 39 publications

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“…The biopsy specimens were mostly cytological specimens, and the collection of histological specimens was challenging. 15,36 Using cell blocks as histological specimens, Žemaitis and colleagues compared the diagnostic accuracy of EBUS-TBNA cytological smears and cell blocks. 37 The results showed that the diagnostic accuracy of cell blocks was higher than that of cytological smears.…”

Section: Discussionmentioning

confidence: 99%

Slow-pull capillary technique versus suction technique in endobronchial ultrasound-guided transbronchial needle aspiration for diagnosing diseases involving hilar and mediastinal lymph node enlargement

Wang

et al. 2020

Ther Adv Respir Dis

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Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a widely used, safe, and accurate technique for obtaining pathological specimens to be used in the diagnosis of diseases involving lung hilar and mediastinal lymph node (LN) enlargement. However, application of the suction technique during EBUS-TBNA remains controversial. In addition, the effectiveness of the slow-pull capillary technique for the diagnosis of pancreatic masses was recently reported. The aim of this study was to compare the diagnostic accuracy of EBUS-TBNA using these two techniques. Methods: The accuracy, sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and availability of tissue cores of the suction and slow-pull capillary techniques were studied retrospectively in patients who underwent EBUS-TBNA for the diagnosis of diseases involving lung hilar and mediastinal LN enlargement. Results: A total of 97 patients with hilar and mediastinal LN enlargement underwent EBUS-TBNA; 30 patients underwent the suction technique, 56 patients underwent the slow-pull capillary technique, 5 patients underwent both techniques, and 6 patients had failed operations. The accuracy, sensitivity, specificity, NPV, PPV, and the number of tissue cores obtained with the suction and slow-pull capillary techniques were 66.67% versus 85.71% ( p = 0.039), 43.75% versus 85.42% ( p < 0.001), 92.86% versus 87.5% ( p > 0.05), 59.09% versus 50% ( p > 0.05), 87.5% versus 97.62% ( p > 0.05), and 19 versus 50 ( p = 0.004), respectively. In both univariate and multivariate analyses, the acquisition of tissue core was significantly associated with the diagnostic accuracy of EBUS-TBNA. Moreover, the slow-pull capillary technique was significantly associated with the acquisition of tissue core in EBUS-TBNA. There were no significant differences between the two groups in the blood contamination of samples. Conclusions: Use of the slow-pull capillary technique in EBUS-TBNA can significantly increase the accuracy related to the diagnosis of diseases involving hilar and mediastinal LN enlargement by improving the acquisition of tissue core. The reviews of this paper are available via the supplemental material section.

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Section: Discussionmentioning

confidence: 99%

Slow-pull capillary technique versus suction technique in endobronchial ultrasound-guided transbronchial needle aspiration for diagnosing diseases involving hilar and mediastinal lymph node enlargement

Wang

et al. 2020

Ther Adv Respir Dis

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“…Fine-needle sampling without the use of aspiration, i.e., capillary sampling, has been investigated in various tissues (e.g., breast, thyroid, and peripheral lymph nodes [LNs]) and shown to have similar diagnostic yield and cause less trauma compared to fine-needle aspiration 5,6 . However, the use of EBUS-guided needle capillary sampling (EBUS-TBNCS) has been described only in a limited number of studies [7][8][9][10][11] .…”

Section: Introductionmentioning

confidence: 99%

Contribution of aspiration to the diagnosis of lung cancer in endobronchial ultrasound-guided fine-needle biopsy

Güven

Yalçınsoy

Akatlı

et al. 2021

Rev. Assoc. Med. Bras.

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OBJECTIVE: Endobronchial ultrasound-guided transbronchial needle aspiration has been successfully applied in both diagnosis and staging of mediastinal and hilar lymphadenopathies and masses, especially in malignant cases. However, the optimal procedure of Endobronchial ultrasound-guided transbronchial needle aspiration to further increase diagnostic yield and minimize processing complexity remains controversial. This study aims to compare aspiration biopsy (Endobronchial ultrasound-guided transbronchial needle aspiration) and non-aspiration biopsy (Endobronchial ultrasound-guided transbronchial needle capillary sampling) in terms of sample adequacy, diagnosis, and quality in malignant cases.METHODS: Between March 2018 and June 2020, Endobronchial ultrasound-guided was performed sequentially on patients with mediastinal and/or hilar lymph nodes that were considered malignant. Each lymphadenopathy was sampled with and without aspiration.A single-blinded pathologist evaluated the samples.RESULTS: A total of 84 lymph nodes evaluations of 51 patients were included. Most samples were taken from the right lower paratracheal lymph nodes (n=27, 32.2%) and subcarinal LN (n=21, 25%). The mean size of the lymph nodes was 21. 21±8.257 (8-40) mm.The agreement between the two procedures in terms of sample adequacy and diagnostic yield was 69.1% (95%CI 58-78.7, p=0.076).In addition, according to the goodness-of-fit statistics, the kappa values were 0.255 (p=0.015) and 0.302 (p=0.004) for sample adequacy and diagnostic yield, respectively. There was no difference between the two procedures in relation to complications.CONCLUSION: Although the agreement between the two procedures is weak, Endobronchial ultrasound-guided transbronchial needle capillary sampling can be performed with less personnel, without reducing diagnostic yield and tissue adequacy. These findings can assist clinicians in determining the optimal procedure for Endobronchial ultrasound-guided.

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“…This effect is the result of the cohesion forces, known as surface tension, which are present between the molecules of the liquid. 7 TBNCS can be used as a means of obtaining lymph node samples, as the cells are not bonded in a compact ultrastructure and can rise through the interior of the needle by capillarity as the stylet is withdrawn. 8 This less-adhesive nature of cells gets more accentuated in squamous cell carcinoma of the lung.…”

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confidence: 99%

Myths and Legends

Sharma

Hovda

Bellinger

2014

Clinical Pulmonary Medicine

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Transbronchial needle sampling during bronchoscopy is a commonly performed procedure that can assist during diagnosis and staging of lung cancer. Typically, suction is applied during transbronchial needle aspiration but a number of studies have examined the role of transbronchial needle capillary sampling in which no suction is applied. We review the available literature to evaluate the myth that suction is always necessary and that it yields a better sample.

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Modified Technique for Obtaining Mediastinal Samples With Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: Results From a Prospective Observational Study

Cited by 6 publications

References 39 publications

Slow-pull capillary technique versus suction technique in endobronchial ultrasound-guided transbronchial needle aspiration for diagnosing diseases involving hilar and mediastinal lymph node enlargement

Slow-pull capillary technique versus suction technique in endobronchial ultrasound-guided transbronchial needle aspiration for diagnosing diseases involving hilar and mediastinal lymph node enlargement

Contribution of aspiration to the diagnosis of lung cancer in endobronchial ultrasound-guided fine-needle biopsy

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