Conventional versus Ultrasound-Guided Transbronchial Needle Aspiration for the Diagnosis of Hilar/Mediastinal Lymph Adenopathies: A Randomized Controlled Trial

Respiration; International Review of Thoracic Diseases
Martina BonifaziStefano Gasparini

Abstract

Conventional transbronchial needle aspiration (c-TBNA) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) are both valuable diagnostic techniques for the diagnosis of hilar/mediastinal lesions. Although a superiority of EBUS-TBNA over c-TBNA may be expected, evidence-based data on a direct comparison between these 2 procedures are still lacking. We aimed to test the superiority of EBUS-TBNA over c-TBNA in a randomized trial and to evaluate the cost-effectiveness profile of a staged strategy, including c-TBNA as initial test followed by EBUS-TBNA, in case of inconclusive results at rapid on-site evaluation. Eligible patients were randomized 1:1 to either the EBUS-TBNA or c-TBNA group. The primary endpoint was to test the superiority of EBUS-TBNA sensitivity over c-TBNA. The secondary endpoints included the sensitivity of the staged strategy, as well as costs and safety related to each procedure and to their sequential combination. A total of 253 patients were randomized to either EBUS-TBNA (n = 127) or c-TBNA (n = 126), and 31 patients of the c-TBNA group subsequently underwent EBUS-TBNA. The sensitivity of EBUS-TBNA was higher, but not significantly superior to that of c-TBNA (respectively. 92% [95...Continue Reading

Citations

Apr 28, 2018·The European Respiratory Journal·Ramón Rami-PortaIvan Vollmer
Jul 6, 2019·Nature Reviews. Disease Primers·Johan GrunewaldJoachim Müller-Quernheim
Aug 31, 2019·Journal of Clinical Medicine·Cecília PedroPatrícia Caetano Mota
Jun 25, 2021·Frontiers in Molecular Biosciences·Fen LanYang Xia
Apr 15, 2019·Respiration; International Review of Thoracic Diseases·Filippo NataliRocco Trisolini

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