Transbronchial Needle Aspiration

Dasgupta, Asok; Mehta, Atul C.; Wang, Ko‐Pen

doi:10.1055/s-2007-1009373

Cited by 48 publications

(28 citation statements)

References 55 publications

(81 reference statements)

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“…In 1979, OHO et al [12] introduced a flexible needle that could be utilised through a flexible fibrebronchoscope and in 1983, WANG and co-workers [13,14] reported the use of TBNA for lung cancer staging and developed new types of needles. Subsequent publications highlighted the use of the technique in the diagnosis of endobronchial and peripheral lesions and the ability of TBNA to provide a diagnosis even in the absence of endobronchial disease [15][16][17][18][19][20][21][22][23]. In the present instalment in this series, the role of TBNA in the management of mediastinal lesions is examined and technical considerations essential to the TBNA procedure are addressed.…”

Section: Transbronchial Needle Aspirationmentioning

confidence: 99%

“…The cases of haemomediastinum [49,51], one caused by histology needle [49], showed spontaneous resolution of the mediastinal haematoma after 1 week. One of the major complications of TBNA is the possible severe damage to the working channel of the scope [18]. This is more frequent with nonretractable needles (that should no longer be available) and can be avoided if the operator takes care in introducing and extracting the needle from the bronchoscope with the tip completely retracted in the sheath.…”

Section: Complicationsmentioning

confidence: 99%

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Transbronchial and transoesophageal (ultrasound-guided) needle aspirations for the analysis of mediastinal lesions

Herth

Rabe²,

Gasparini³

et al. 2006

Eur Respir J

138

103

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A tissue diagnosis of mediastinal nodes is frequently needed for accurate lung cancer staging as well as the assessment of mediastinal masses. Transbronchial needle aspiration (TBNA) is a safe procedure that is performed during routine bronchoscopy. Provided mediastinal metastases are confirmed, TBNA has a high impact on patient management. Unfortunately, TBNA remains underused in current daily practice, mainly due to the lack of realtime needle visualisation. The introduction of echo-endoscopes has overcome this problem.Endobronchial ultrasound-guided TBNA (EBUS-TBNA) allows real-time controlled tissue sampling of paratracheal, subcarinal and hilar lymph nodes. Mediastinal lymph nodes located adjacent to the oesophagus can be assessed by transoesophageal ultrasound-guided fine needle aspiration (EUS-FNA). Owing to the complementary reach of EBUS-TBNA and EUS-FNA in assessing different regions of the mediastinum, recent studies suggest that complete and accurate mediastinal staging can be achieved by the combination of both procedures.It is expected that implementation of minimally invasive endoscopic methods of endobronchial ultrasound-guided transbronchial needle aspiration and transoesophageal ultrasound-guided fine needle aspiration will reduce the need for surgical staging of lung cancer significantly.

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Section: Transbronchial Needle Aspirationmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

Transbronchial and transoesophageal (ultrasound-guided) needle aspirations for the analysis of mediastinal lesions

Herth

Rabe²,

Gasparini³

et al. 2006

Eur Respir J

138

103

View full text Add to dashboard Cite

show abstract

“…The procedure is safe with few complications documented in the literature (1)(2)(3)(4)(5)(6)(7)9,10). This is comparable with a complication rate for cervical mediastinoscopy of 2.5% (11).…”

Section: Discussionmentioning

confidence: 67%

Cost Effectiveness of Transbronchial Needle Aspiration

Crocket

Wong

Lien

et al. 1999

Canadian Respiratory Journal

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OBJECTIVE:To evaluate the yield and cost effectiveness of transbronchial needle aspiration (TBNA) in the assessment of mediastinal and/or hilar lymphadenopathy. DESIGN: Retrospective study. SETTING: A university hospital. POPULATION STUDIED: Ninety-six patients referred for bronchoscopy with computed tomographic evidence of significant mediastinal or hilar adenopathy. RESULTS: Ninety-nine patient records were reviewed. Three patients had two separate bronchoscopy procedures. TBNA was positive in 42 patients (44%) and negative in 54 patients. Of the 42 patients with a positive aspirate, 40 had malignant cytology and two had cells consistent with benign disease. The positive TBNA result altered management in 22 of 40 patients with malignant disease and one of two patients with benign disease, thereby avoiding further diagnostic procedures. The cost of these subsequent procedures was estimated at $27,335. No complications related to TBNA were documented. CONCLUSIONS: TBNA is a high-yield, safe and cost effective procedure for the diagnosis and staging of bronchogenic cancer.

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“…The insertion point was determined after a careful analysis of thoracic CT and following previous recommendations by other authors [5,6]. TBNA was carried out at the most accessible and largest adenopathy when there were several lymph node enlargements.…”

Section: Tbna Proceduresmentioning

confidence: 99%

Role of Transbronchial Needle Aspiration in Patients with Thoracic Lymphadenopathy on CT Scan

Mukul¹

2013

AJIM

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Abstract:Context: Transbronchial needle aspiration (TBNA) is a method in which an aspirating needle is used to obtain diagnostic samples from a peribronchial or submucosal lesion through a rigid [1] or flexible bronchoscope [2]. Though it is a very useful bronchoscopic technique it still remains underutilized [3]. Aims: This study was done to evaluate the sensitivity, complication rates and factors affecting the outcome of TBNA. Settings and Design: Prospective trial of fifty two patients with mediastinal lymphadenopathy on CT scan attending Respiratory Diseases Clinic of Jawaharlal Nehru Medical College Hospital. Methods and Material: We analyzed the outcome of TBNA in fifty two patients who underwent TBNA between 2010 and 2012. Sensitivity of TBNA was calculated and factors affecting the TBNA results were analyzed. Statistical analysis used:Chi square test was used for analyzing the factors affecting TBNA results. SPSS Statistics 17.0 was used for analysis. Results: The overall sensitivity of TBNA was found to be 59.6% and it was the only diagnostic technique in 47.6% of the patients. Factors associated with diagnostic acquisition of samples were lymph node size more than 1.5 cm and the presence of indirect signs on bronchoscopy. Conclusions: The sensitivity of TBNA is high in malignant mediastinal lymphadenopathy. Complications occurred in four patients who had self limited bleeding at the site of puncture which healed spontaneously. Important factors predicting the outcome of TBNA are lymph node size and the presence of indirect signs on bronchoscopy. We would recommend this procedure for detection of metastatic lymph nodes in patients with lung cancer and also for mediastinal tubercular lymphadenopathy where diagnosis could not be achieved by less invasive methods.

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Transbronchial Needle Aspiration

Cited by 48 publications

References 55 publications

Transbronchial and transoesophageal (ultrasound-guided) needle aspirations for the analysis of mediastinal lesions

Transbronchial and transoesophageal (ultrasound-guided) needle aspirations for the analysis of mediastinal lesions

Cost Effectiveness of Transbronchial Needle Aspiration

Role of Transbronchial Needle Aspiration in Patients with Thoracic Lymphadenopathy on CT Scan

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