Open AccessLearning endobronchial ultrasound transbronchial needle aspiration – a 6‐year experience at a single institution
Author(s) -
Sørhaug Sveinung,
Hjelde Harald,
Hatlen Peter,
Leira Håkon Olav,
Salarinejad Majid,
Nesvik Bjarte,
Hollund Raymond,
Nesgård Kristin,
Nordhaug Dag Ole,
Amundsen Tore
Publication year - 2018
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12475
Subject(s) - medicine , pulmonologist , endobronchial ultrasound , lung cancer , radiology , malignancy , bronchoscopy , population , sarcoidosis , mediastinal lymphadenopathy , biopsy , intensive care medicine , environmental health
Endobronchial ultrasound with transbronchial needle aspiration (EBUS‐TBNA) has become an important diagnostic tool for the pulmonologist. Learning this procedure and maintaining technical skills requires continuous practice and evaluation. Objectives The aims of the study were a retrospective evaluation of the diagnostic quality of the EBUS‐technique and the learning profile of the endoscopy team during the first years (2007–2013) of experience in an unselected population. Methods EBUS‐TBNA procedures were analysed for clinical data, including results from surgery or clinical/radiological follow‐up for at least 6 months. Rapid on‐site cytological evaluation (ROSE) was introduced on regular basis the forth year. Results A total of 711 EBUS‐TBNA from 635 patients were included. The percentage of representative EBUS‐TBNA initially decreased the first years (minimum 60,9%), before increased to a final result of 82,4%. There was a lower proportion of representative EBUS‐TBNA in the benign group (76,8%) vs the malignant group (85,8%). A significant increase in the proportion of representative EBUS‐TBNA was seen after ROSE had been introduced. The major indications were diagnosing/staging of lung cancer (54%) and mediastinal lymphadenopathy of unknown cause (25,7%). The sensitivity detecting malignancy was 94,9%, negative predictive value 81,2% and diagnostic accuracy 95,8%. During the study period the percentage of re‐examinations with EBUS‐TBNA declined from 18,0% to 8,2%. Conclusion After an initial run‐in period with declining results, the overall diagnostic yield of EBUS‐TBNA increased and reached acceptable levels. These results underline the importance of continuously evaluation of our own results when new methods are implemented in clinical practice.