Ebus Tbna - Jbm 130318 4d2z5p
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Endobronchial Ultrasound and Transbronchial Needle Aspiration (EBUS-TBNA) Dr Upul Pathirana (Registrar) Dr Jaymin Morjaria (Consultant Respiratory Physician) Harefield Hospital
Background • Mediastinal and hilar lymphadenopathy detected on imaging needs tissue sampling for cytology/ histology and microbiology for the final diagnosis • Mediastinoscopy with lymph node sampling is considered to be the gold standard. EBUS-TBNA has replaced mediastinoscopy which is a more invasive and complicated procedure.
Timeframe (01/01/2016 – 31/12/2017) & distribution 2016 Month
Number of cases
2017 Month
Number of cases
January
6
January
5
February
4
February
8
March
3
March
10
April
9
April
2
May
7
May
8
June
17
June
10
July
8
July
1
August
6
August
13
September
9
September
6
October
11
October
8
November
8
November
8
December
6
December
3
Total
94
Total
82
Lymph Node Hit rate
outcome
2016
2017
Positive lymphoid tissue
88
77
Inadequate sample
6
5
Total number
94
82
Lymph Node Hit rate
93.6%
93.9%
Sampled lymph node stations 2016
2017
Lymph Node Station Sampled 2
2R
17
50
26
Lymph Node Stations Sampled
3
7 15
12 6
4R 4L
2R
31
4R 50
1
7
11
10R 31 55
10R 22
10L 11R
11L
4L
73
10L 11R
11L
Anesthesia and sedation
Anesthesia
Number of cases
Sedation
152
GA
24
Total
176
Complications • Minor bleeding – (1) • Decayed tooth broken (1) • Hypertensive and tachycardia (1) • Extensive gag reflex (1) • Blockage of scope (1)
Conclusions • EBUS is a safe procedure • The lymph node Hit Rate is high however is dependent on the and teamwork.
Thank you
Background • Mediastinal and hilar lymphadenopathy detected on imaging needs tissue sampling for cytology/ histology and microbiology for the final diagnosis • Mediastinoscopy with lymph node sampling is considered to be the gold standard. EBUS-TBNA has replaced mediastinoscopy which is a more invasive and complicated procedure.
Timeframe (01/01/2016 – 31/12/2017) & distribution 2016 Month
Number of cases
2017 Month
Number of cases
January
6
January
5
February
4
February
8
March
3
March
10
April
9
April
2
May
7
May
8
June
17
June
10
July
8
July
1
August
6
August
13
September
9
September
6
October
11
October
8
November
8
November
8
December
6
December
3
Total
94
Total
82
Lymph Node Hit rate
outcome
2016
2017
Positive lymphoid tissue
88
77
Inadequate sample
6
5
Total number
94
82
Lymph Node Hit rate
93.6%
93.9%
Sampled lymph node stations 2016
2017
Lymph Node Station Sampled 2
2R
17
50
26
Lymph Node Stations Sampled
3
7 15
12 6
4R 4L
2R
31
4R 50
1
7
11
10R 31 55
10R 22
10L 11R
11L
4L
73
10L 11R
11L
Anesthesia and sedation
Anesthesia
Number of cases
Sedation
152
GA
24
Total
176
Complications • Minor bleeding – (1) • Decayed tooth broken (1) • Hypertensive and tachycardia (1) • Extensive gag reflex (1) • Blockage of scope (1)
Conclusions • EBUS is a safe procedure • The lymph node Hit Rate is high however is dependent on the and teamwork.
Thank you
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