Pulmonologist-Performed Per-Esophageal Needle Aspiration of Parenchymal Lung Lesions Using an EBUS Bronchoscope
| Autor: | Daniel P Steinfort, Louis Irving, Michael Farmer, Barton R Jennings |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Pulmonary and Respiratory Medicine
Endoscopic ultrasound medicine.medical_specialty Lung Neoplasms Diagnostic accuracy Adenocarcinoma Sensitivity and Specificity Cohort Studies 03 medical and health sciences Postoperative Complications 0302 clinical medicine Bronchoscopy Carcinoma Non-Small-Cell Lung medicine Humans Prospective Studies Endobronchial ultrasound skin and connective tissue diseases Endoscopic Ultrasound-Guided Fine Needle Aspiration neoplasms Pulmonologists Lung medicine.diagnostic_test business.industry Pneumothorax Pulmonologist medicine.disease Small Cell Lung Carcinoma digestive system diseases body regions Bronchoscopes surgical procedures operative medicine.anatomical_structure 030228 respiratory system 030220 oncology & carcinogenesis Carcinoma Squamous Cell Esophagoscopy Radiology Tomography X-Ray Computed business |
| Zdroj: | Journal of Bronchology & Interventional Pulmonology. 24:117-124 |
| ISSN: | 1944-6586 |
| Popis: | Transesophageal introduction of the endobronchial ultrasound (EBUS) videobronchoscope allows pulmonologists to perform endoscopic ultrasound fine-needle aspiration (EUS-B-FNA) of mediastinal lesions. Safety, diagnostic accuracy, and feasibility of EUS-B-FNA in evaluation of pulmonary parenchymal lesions are not established.All patients undergoing pulmonologist-performed EUS-B-FNA of parenchymal lung lesions at 2 tertiary centers were included in this prospective observational cohort study.EUS-B-FNA sampling of parenchymal lesions was performed in 27 patients. Mean (±SD) lesion size was 36±16 mm. Seven lesions were ≤18 mm. Pneumothorax occurred in 1 patient (3.7%, 95% confidence interval, 0.001%-19%). Ten target lesions (36%) were in locations inaccessible to bronchoscopic sampling via the airways, and 9 lesions were inaccessible to EBUS-guided transbronchial needle aspiration and in locations associated with low diagnostic yield from radial EBUS. EUS-B-FNA was diagnostic in 26 patients (96%), and sensitivity of EUS-B-FNA was 100% (95% confidence interval, 87%-100%) for both lung cancer (n=21) and for pulmonary metastatic lesions (n=5).Pulmonologist-performed EUS-B-FNA is safe and accurate in the evaluation parenchymal lung lesions. Diagnostic accuracy is high. EUS-B-FNA may achieve access to sites not amenable to other forms of bronchoscopic sampling, or increase diagnostic accuracy in patients where anatomic position predicts a low diagnostic yield. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|