Author of

• 25925

  +

  P1.05 - Interventional Diagnostics/Pulmonology (Not CME Accredited Session) (ID 937)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall

  • 26479

    +

    P1.05-05 - Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for Suspected Malignancy; Current Status and Issues (ID 13209)

    16:45 - 18:00  |  Presenting Author(s): Hidenao Kayawake
    • Abstract
    • Slides

    Background
    

    The number of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is now increasing, since it is less invasive and useful for the pathological diagnosis of lung cancer or thoracic and hilar lymph node enlargement. However, there are some problems to be solved, such as diagnostic accuracy and complications. Here, we retrospectively reviewed our experiences of EBUS-TBNA performed for diagnosis of malignant diseases.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    Between July 2009 and December 2017, 489 patients underwent EBUS-TBNA. Among them, the subject of this study was 424 cases underwent EBUS-TBNA for diagnosis of malignancy. We retrospectively analyzed the completion rate, the complication rate, the adequate sample collection rate and the diagnostic accuracy of EBUS-TBNA among these 424 patients.

    4c3880bb027f159e801041b1021e88e8 Result
    

    Among all 424 cases, the target lesions of EBUS-TBNA consisted of mediastinal lesions (n=303), hilar lesions (n=69) and both mediastinal and hilar lesions (n=52). Almost all EBUS-TBNAs were performed under conscious anesthesia, while 9 EBUS-TBNAs were performed under general anesthesia. Among 424 cases, EBUS-TBNA was completed in 408 cases (96.2%) and the collection of adequate sample was performed in 382 cases (90.1%). There were four complications (0.94%); they consisted of mediastinal infection (n=2), obstructive pneumonia (n=1) and airway obstruction (n=1). All 4 cases were treated medically and fully recovered. Among 16 incomplete cases, 10 cases were histologically diagnosed with having malignancy; 5 cases were surgically diagnosed, and other 5 cases were diagnosed by EBUS-TBNA under general anesthesia. Other 3 cases were clinically diagnosed with having malignant diseases. Among 26 patients in whom adequate samples were not collected, 14 patients were finally diagnosed with having malignancy. On the other hand, among 382 patients in whom adequate samples were collected, the sensitivity, specificity, positive predictive value and negative predictive value were 90.0%, 100.0%, 100.0% and 76.0%, respectively. Furthermore, the diagnostic accuracy of EBUS-TBNA for hilar lesions was the least among the three lesions (mediastinal: 94.2%, hilar: 83.9%, both mediastinal and hilar: 91.8%, p=0.029).

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Among the patients in whom adequate samples were collected, the outcome of EBUS-TBNA was favorable. Since complications are rare but can happen, early recognition and treatment for complication are important. When EBUS-TBNA under conscious sedation is not completed, EBUS-TBNA under general anesthesia or other diagnostic approaches such as mediastinoscopy and video-assisted thoracoscopic surgery are to be considered.

    6f8b794f3246b0c1e1780bb4d4d5dc53

    Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.