PLoS ONE (Jan 2013)

Usefulness of high suction pressure for sufficient tissue collection during endobronchial ultrasound guided transbronchial needle aspiration.

  • Takayuki Shiroyama,
  • Norio Okamoto,
  • Hidekazu Suzuki,
  • Motohiro Tamiya,
  • Tadahiro Yamadori,
  • Naoko Morishita,
  • Tomoyuki Otsuka,
  • Satomu Morita,
  • Kanako Kurata,
  • Akira Okimura,
  • Kunimitsu Kawahara,
  • Shinji Sasada,
  • Tomonori Hirashima,
  • Ichiro Kawase

DOI
https://doi.org/10.1371/journal.pone.0082787
Journal volume & issue
Vol. 8, no. 12
p. e82787

Abstract

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INTRODUCTION: The optimal suction pressure during endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) remains to be determined. The aim of this study was to compare suction pressures for performance in collecting sufficient tissue specimens from mediastinal and hilar lymph nodes during EBUS-TBNA. METHODS: Retrospective analysis of consecutive patients with mediastinal and hilar lymphadenopathy who underwent EBUS-TBNA over a 3-year period. Results from patients who underwent EBUS-TBNA using a dedicated 20-mL VacLoc (Merit Medical Systems, Inc, South Jordan, UT) syringe (conventional method, group C) were compared with results from patients in whom a disposable 30-mL syringe (high pressure group, group H) was used. The yield for sufficient histologic specimen retrieval and amount of tissue obtained were compared between the 2 groups. RESULTS: Of 178 patients who underwent EBUS-TBNA, 131 had lung cancer confirmed by EBUS-TBNA: 35 in group C and 96 in group H. There were 7 patients in group C and 6 in group H who received final diagnoses by cytology alone. There were 28 in group C and 90 in group H who were diagnosed by both cytology and histology. There was a statistically significant difference between the groups in terms of the rate of sufficient sampling for histological specimens (p = 0.04). The H group revealed a tissue area approximately twice that of the C group (p = 0.003). There were no major procedure-related complications in either group. CONCLUSION: Higher suction pressures with larger syringe volumes during EBUS-TBNA may be useful for safely collecting sufficient tissue specimens.