BACKGROUND AND AIM: Real-time endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive technique for diagnosis of mediastinal lymphadenopathy. Although most studies have reported the utility of EBUS-TBNA in malignancy, its use has been extended to benign conditions including sarcoidosis. Herein, we perform a systematic review and meta-analysis of studies reporting the diagnostic yield and safety of EBUS-TBNA in sarcoidosis. METHODS: We searched the PubMed and EmBase databases for relevant studies published from 2004 to 2011, and included studies that have reported the diagnostic yield of EBUS-TBNA in sarcoidosis. The quality of studies was assessed using the QualSyst tool. We calculated the proportions with 95% confidence interval (CI) to assess the diagnostic yield of EBUS-TBNA in individual studies and then pooled the results using a random effects model. Heterogeneity was assessed using the I(2) and Cochran-Q tests while publication bias was assessed using both graphical and statistical methods. RESULTS: Our search yielded 15 studies (553 patients of sarcoidosis). The diagnostic yield of EBUS-TBNA ranged from 54 to 93% with the pooled diagnostic accuracy being 79% (95% CI, 71-86%) by the random effects model. The yield was not statistically different in studies employing on-site cytological evaluation (80.1%) vs. those without (81.3%). However, the diagnostic yield was significantly higher in prospective studies (83.9%) vs. the retrospective studies (74.3%). Only five minor complications were reported in 553 patients. There was evidence of heterogeneity and publication bias. CONCLUSIONS: EBUS-TBNA is a safe and efficacious procedure in the diagnosis of sarcoidosis, and should be routinely employed wherever available.
BACKGROUND AND AIM: Real-time endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive technique for diagnosis of mediastinal lymphadenopathy. Although most studies have reported the utility of EBUS-TBNA in malignancy, its use has been extended to benign conditions including sarcoidosis. Herein, we perform a systematic review and meta-analysis of studies reporting the diagnostic yield and safety of EBUS-TBNA in sarcoidosis. METHODS: We searched the PubMed and EmBase databases for relevant studies published from 2004 to 2011, and included studies that have reported the diagnostic yield of EBUS-TBNA in sarcoidosis. The quality of studies was assessed using the QualSyst tool. We calculated the proportions with 95% confidence interval (CI) to assess the diagnostic yield of EBUS-TBNA in individual studies and then pooled the results using a random effects model. Heterogeneity was assessed using the I(2) and Cochran-Q tests while publication bias was assessed using both graphical and statistical methods. RESULTS: Our search yielded 15 studies (553 patients of sarcoidosis). The diagnostic yield of EBUS-TBNA ranged from 54 to 93% with the pooled diagnostic accuracy being 79% (95% CI, 71-86%) by the random effects model. The yield was not statistically different in studies employing on-site cytological evaluation (80.1%) vs. those without (81.3%). However, the diagnostic yield was significantly higher in prospective studies (83.9%) vs. the retrospective studies (74.3%). Only five minor complications were reported in 553 patients. There was evidence of heterogeneity and publication bias. CONCLUSIONS: EBUS-TBNA is a safe and efficacious procedure in the diagnosis of sarcoidosis, and should be routinely employed wherever available.
Authors: Christoph Frank Dietrich; Jouke Tabe Annema; Paul Clementsen; Xin Wu Cui; Mathias Maximilian Borst; Christian Jenssen Journal: J Thorac Dis Date: 2015-09 Impact factor: 2.895
Authors: Christian Jenssen; Jouke Tabe Annema; Paul Clementsen; Xin-Wu Cui; Mathias Maximilian Borst; Christoph Frank Dietrich Journal: J Thorac Dis Date: 2015-10 Impact factor: 2.895
Authors: Kyle Bramley; Margaret A Pisani; Terrence E Murphy; Katy L Araujo; Robert J Homer; Jonathan T Puchalski Journal: Ann Thorac Surg Date: 2016-02-22 Impact factor: 4.330
Authors: Yi Xiang; Faming Zhang; Jason Akulian; Lonny Yarmus; David Feller-Kopman; Ko Pen Wang Journal: J Thorac Dis Date: 2013-02 Impact factor: 2.895
Authors: Francys C Verdial; Kathleen S Berfield; Douglas E Wood; Michael S Mulligan; Joshua A Roth; David O Francis; Farhood Farjah Journal: Chest Date: 2019-10-09 Impact factor: 9.410