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document
Endobronchial ultrasonography-guided transbronchial needle aspiration increases the diagnostic yield of peripheral pulmonary lesions : a randomized trial . BACKGROUND The diagnostic yield of endobronchial ultrasonography ( EBUS ) -guided transbronchial needle aspiration ( TBNA ) for peripheral pulmonary lesions ( PPLs ) has not been evaluated . The diagnostic impact of TBNA when the EBUS probe is adjacent to lesions remains to be determined . DESIGN A prospective , randomized trial . METHODS Two hundred two patients with PPLs and positive EBUS findings were enrolled . They were randomly classified into two groups . In the EBUS conventional diagnostic procedures ( CDPs ) group ( 103 patients ) , both transbronchial biopsy ( TBB ) and bronchial washing ( BW ) were performed . In the EBUS-TBNA plus CDPs group ( 99 patients ) , TBNA , TBB , and BW were performed . The diagnostic yield in each group was compared . RESULTS A total of 182 patients ( 94 in the EBUS CDPs group and 88 in the EBUS-TBNA plus CDPs group ) were analyzed . The yield in the EBUS-TBNA plus CDPs group ( 78.4 % ) was significantly higher than the EBUS CDPs group ( 60.6 % , p = 0.015 ) . Cases in which the EBUS probe was located within the lesions had a significantly higher diagnostic yield ( 78.3 % ) than when the EBUS probe was adjacent to them ( 47.2 % , p < 0.001 ) . Concerning the three different techniques , TBNA showed the highest diagnostic yield ( 62.5 % ) in comparison to TBB ( 48.9 % ) and to BW ( 19.8 % ) . The diagnostic yield of TBNA remained unchanged even when the EBUS probe was adjacent to the lesions ( p = 0.89 ) . No additional adverse effects were observed in the EBUS-TBNA plus CDPs group . CONCLUSIONS Applying TBNA to EBUS-guided CDPs further increased the diagnostic yield of PPLs without additional risk . The diagnostic advantage of TBNA became more obvious if the EBUS probe was adjacent to the lesions . TRIAL REGISTRATION Clinicaltrials.gov Identifier : NCT00626587 .
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Intervention_Surgical
transbronchial needle aspiration
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Intervention_Surgical
endobronchial ultrasonography ( EBUS ) -guided transbronchial needle aspiration ( TBNA )
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Intervention_Physical
transbronchial biopsy
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Outcome_Other
diagnostic yield
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Outcome_Physical
diagnostic yield
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Outcome_Physical
diagnostic yield
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Outcome_Other
yield in the EBUS-TBNA
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Outcome_Physical
higher diagnostic yield
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Outcome_Physical
highest diagnostic yield
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Outcome_Physical
diagnostic yield of TBNA
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Outcome_Adverse-effects
adverse effects
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Outcome_Physical
diagnostic yield
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Outcome_Other
diagnostic advantage
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Participant_Condition
peripheral pulmonary lesions :