Kay-Leong Khoo1, Gerald S W Chua, Amartya Mukhopadhyay, T K Lim. 1. Division of Respiratory Medicine, Department of Medicine, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore. Khookl@nuh.com.sg
Abstract
BACKGROUND: Transbronchial needle aspiration (TBNA) has been shown to be useful not only for the diagnosis and staging of lung cancer, its most widely studied indication, but also for many of other clinical indications. Despite this, it remains largely underutilized, mainly because of concerns with poor yield, safety, lack of experience of the bronchoscopist, and lack of cytopathological support. OBJECTIVE: To study the clinical utility and yield of TBNA as an adjunct to other conventional procedures in diagnostic bronchoscopy at a centre that was relatively inexperienced with this technique, but where there was availability of rapid on-site evaluation (ROSE). Most of the major indications for TBNA in both malignant as well as benign disease were included. SETTING: University Teaching Hospital naïve to the procedure. PATIENT AND METHODS: Forty-five consecutive patients who underwent TBNA as part of diagnostic bronchoscopy during a 2-year study period. RESULTS: TBNA gave a yield of 65% for evaluation of mediastinal disease, both benign and malignant. The overall diagnostic utility for all indications was 71% and there were no complications. CONCLUSIONS: We conclude that TBNA is a useful and safe adjunct to diagnostic bronchoscopy in routine clinical practice. It has a satisfactory yield even with an inexperienced team, if used with ROSE.
BACKGROUND: Transbronchial needle aspiration (TBNA) has been shown to be useful not only for the diagnosis and staging of lung cancer, its most widely studied indication, but also for many of other clinical indications. Despite this, it remains largely underutilized, mainly because of concerns with poor yield, safety, lack of experience of the bronchoscopist, and lack of cytopathological support. OBJECTIVE: To study the clinical utility and yield of TBNA as an adjunct to other conventional procedures in diagnostic bronchoscopy at a centre that was relatively inexperienced with this technique, but where there was availability of rapid on-site evaluation (ROSE). Most of the major indications for TBNA in both malignant as well as benign disease were included. SETTING: University Teaching Hospital naïve to the procedure. PATIENT AND METHODS: Forty-five consecutive patients who underwent TBNA as part of diagnostic bronchoscopy during a 2-year study period. RESULTS:TBNA gave a yield of 65% for evaluation of mediastinal disease, both benign and malignant. The overall diagnostic utility for all indications was 71% and there were no complications. CONCLUSIONS: We conclude that TBNA is a useful and safe adjunct to diagnostic bronchoscopy in routine clinical practice. It has a satisfactory yield even with an inexperienced team, if used with ROSE.