Does a short training in EBUS guided TBNA improve yield of conventional TBNA?

Lt Col (Dr) Manu Chopra; Lt Col (Dr) GPS Gahlot; Brig (Dr) Vasu Vardhan

Volume : VII, Issue : VII, July - 2018

Does a short training in EBUS guided TBNA improve yield of conventional TBNA?

Lt Col Dr Manu Chopra, Lt Col Dr Gps Gahlot, Brig Dr Vasu Vardhan

Abstract :

Introduction: Conventional Trans onchial needle aspiration(c–TBNA) is a blind procedure guided by CT picture & experience, thus yield is usually poor. Endoonchial Ultrasound (EBUS) guided TBNA helps to visualize mediastinal lymph nodes[LN] in real time, thereby improving yield. A better understanding of mediastinal anatomy as seen with EBUS should help in improving c–TBNA yield. We, thus, analyzed our c–TBNA results pre–& post short EBUS–TBNA training.

Aim: Does a short training in EBUS guided TBNA improve yield of c–TBNA

Methods: An experimental study was carried out to compare outcomes of 300 c–TBNA’s performed pre–& post EBUS–TBNA training using chi square test.

Results: Out of 300c–TBNA’s carried out pre EBUS training, 50 yielded results, whereas, 130 out of 300 yielded results post training. An improvement of over two and a half times was seen.

Conclusion: Bronchoscopists are expert in various endoonchial procedures. The unguided nature of c–TBNA, wherein, knowledge acquired from charts, diagrams & CT films leads to poor localization of mediastinal LN’s yielding poor results. EBUS–TBNA though helps in real time visualization and sampling of mediastinal LN’s, is not easily available due to cost. Various workshops are being carried out to teach EBUS –TBNA. Bronchoscopists who are master in c–TBNA procedure will surely improve their yield of c–TBNA post undergoing training in EBUS–TBNA, as the same would improve their mental picture of localization of various mediastinal LN’s.