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首页> 外文期刊>Surgical Endoscopy >A strategy to improve the yield of transbronchial needle aspiration.
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A strategy to improve the yield of transbronchial needle aspiration.

机译：一种提高经支气管针吸出率的策略。

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BACKGROUND: Transbronchial needle aspiration (TBNA) is a bronchoscopic technique that provides access to masses within the mediastinum. It is operator dependent, and factors such as needle type, lymph node site, and endobronchial ultrasosonography (EBUS) have been implicated as having an impact on its accuracy. This study aimed to develop a strategy for TBNA and specimen preparation techniques as the first step toward improving TBNA yield, and to determine whether EBUS can augment its application. METHODS: Intervention included standardizing the use of the histology needle and the direct smear method. As competency improved, radial probe (RP) and linear EBUS were incorporated into TBNA. RESULTS: The study assessed 35 conventional TBNA procedures before and 45 of these procedures after intervention as well as 45 RP-EBUS and 50 linear EBUS-guided TBNA procedures. Frequently sampled lymph node stations were 7, 4R, and 4L in the American Thoracic Society classification. The preintervention conventional TBNA yield was 43%, which improved to 82% after intervention. Although EBUS did not have an impact on TBNA yield (p = 0.44) compared with the intervention (p = 0.001), EBUS was useful for lymph nodes smaller than 2 cm (p < 0.0001). Linear EBUS did not confer higher diagnostic accuracy than RP-EBUS (p = 0.47). CONCLUSION: Proper TBNA and specimen preparation techniques are the first steps toward improving TBNA yield, and EBUS can be used to guide TBNA of small lymph nodes.
机译：背景：经支气管针吸术（TBNA）是一种支气管镜技术，可提供对纵隔内肿块的访问。它取决于操作员，并且涉及诸如针头类型，淋巴结部位和支气管内超声（EBUS）之类的因素，对其准确性有影响。这项研究旨在制定TBNA和标本制备技术的策略，作为提高TBNA产量的第一步，并确定EBUS是否可以扩大其应用。方法：干预包括标准化组织学针的使用和直接涂片法。随着能力的提高，径向探针（RP）和线性EBUS被合并到TBNA中。结果：该研究评估了干预之前和之后的35例常规TBNA程序，以及45例RP-EBUS和50例线性EBUS指导的TBNA程序。在美国胸科学会分类中，经常采样的淋巴结站分别为7、4R和4L。干预前常规TBNA的产率为43％，干预后提高到82％。尽管与干预措施（p = 0.001）相比，EBUS对TBNA的产生没有影响（p = 0.44），但是EBUS对于小于2 cm的淋巴结有用（p <0.0001）。线性EBUS不能提供比RP-EBUS更高的诊断准确性（p = 0.47）。结论：正确的TBNA和标本制备技术是提高TBNA产量的第一步，EBUS可用于指导小淋巴结的TBNA。

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