Interventional Pulmonology

Konno-Yamamoto A.a,b,c· Matsumoto Y.a,b· Imabayashi T.a· Tanaka M.a· Uchimura K.a· Nakagomi T.a· Yanase K.a· So C.a,b· Ohe Y.b· Tsuchida T.a

Author affiliations

aDepartment of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
bDepartment of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
cDepartment of Respiratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

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Article / Publication Details

First-Page Preview

Received: February 01, 2022
Accepted: December 07, 2022
Published online: December 21, 2022

Number of Print Pages: 11
Number of Figures: 5
Number of Tables: 3

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: https://www.karger.com/RES

Abstract

Background: Endobronchial ultrasound (EBUS)-guided intranodal forceps biopsy (IFB), a diagnostic bronchoscopic technique for intrathoracic lymphadenopathy, is performed following EBUS-guided transbronchial needle aspiration (TBNA). The current EBUS-IFB technique is complex and provides small sample volumes. We modified this technique to allow the use of standard-sized forceps. Objectives: The aim of this study was to assess the feasibility of the modified EBUS-IFB technique, which combines standard-sized forceps with standard EBUS-TBNA equipment. Method: This retrospective analysis included consecutive patients scheduled for EBUS-TBNA with attempted additional IFB between July 2020 and March 2021. The feasibility indices of IFB, technical success rate, diagnostic accuracy, and major complications were retrospectively investigated. We performed semi-quantitative evaluation of the histological specimens and univariable analyses to identify factors associated with IFB failure. Results: During the study period, 295 patients underwent 307 EBUS-TBNAs; 195 cases were included in the analyses. Target lesions were mainly mediastinal lymph nodes (134 cases, 68.7%); the most frequent sites were #7 (61 cases) and #4R (50 cases). The median lesion size was 16.1 mm, the technical IFB success rate was 90.8%, and the diagnostic accuracy of the TBNA and IFB combination was 99.5%. One patient was lost to follow-up. Univariable analyses did not identify any factors involved in technical IFB failure. Major complications of pneumonia and pneumothorax occurred in 2 cases (1.0%). The median histological score was significantly higher in the IFB group than in the TBNA group (1.67 vs. 1.50, p = 0.032). Conclusions: Modified EBUS-IFB, combining standard-sized forceps with common EBUS-TBNA equipment, is feasible with few major complications.

© 2022 S. Karger AG, Basel

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First-Page Preview

Received: February 01, 2022
Accepted: December 07, 2022
Published online: December 21, 2022

Number of Print Pages: 11
Number of Figures: 5
Number of Tables: 3

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: https://www.karger.com/RES

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