Open AccessThoracic endosonography (EBUS/EUS‐b) in the diagnosis of different intrathoracic diseases: A 4‐year experience at a single‐centre in Greece
Author(s) -
Chrysikos Serafeim,
Karampitsakos Theodoros,
Zervas Eleftherios,
Anyfanti Maria,
Papaioannou Ourania,
Tzouvelekis Argyrios,
Hillas Georgios,
Dimakou Katerina
Publication year - 2021
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.13684
Subject(s) - medicine , malignancy , radiology , sarcoidosis , mediastinal lymphadenopathy , lung cancer , bronchoscopy , diagnostic accuracy , prospective cohort study , biopsy
Background In the last decade, the advent of thoracic endosonography has revolutionised the field of diagnostic bronchoscopy. Methods We conducted a single‐centre prospective study in “Sotiria” Chest diseases hospital between January 2016 and December 2019. The study aimed to evaluate the efficacy and diagnostic value of combined EBUS/EUS‐b in comparison with EBUS‐TBNA and EUS‐b FNA in different intrathoracic diseases. Results A total of 266 patients were enrolled (70.7% males, 85.7% smokers, mean age ± SD: 62.8 ± 11.8). Diagnosis and staging of suspected lung cancer (LC) were the main indications for EBUS/EUS‐b in 56.7% of patients, followed by lymphadenopathy of unknown origin in 27%, lymphadenopathy in previous malignancy in 10.9%, and staging of proven LC in 5.3%. EUS‐b FNA alone or combined with EBUS‐TBNA was performed in 14.7% of patients. A total of 512 lymph nodes was sampled (481 through EBUS‐TBNA and 31 through EUS‐b FNA). EBUS/EUS‐b led to a definitive diagnosis in 68.4% of the patients. Most cases (50.4%) were malignancies, while 18% represented benign diseases (83.3% sarcoidosis). Sensitivity of combined EBUS/EUS‐b was higher in comparison with sensitivity of both procedures alone (100% vs 89.4% vs 88.9%). Accordingly, the overall sensitivity of EBUS/EUS‐b for the detection of malignancy and sarcoidosis was 93% and 95.2%, respectively. No severe complications were observed. Conclusion Thoracic endosonography is an efficient, safe, minimally invasive tool yielding high sensitivity and diagnostic accuracy in patients with suspected malignancy and mediastinal lymphadenopathy. Experienced pulmonologists in EBUS‐TBNA should more routinely perform EUS‐b FNA to avoid unnecessary surgical interventions.