Soner GÜRSOY, Ahmet ÜÇVET, Ozan USLUER, Şeyda ÖRS KAYA

Endobronchial ultrasound-guided transbronchial needle aspiration: a retrospective analysis of 228 patients

Amaç: Bu çalışmada, malign ve benign hastalıklarda endobronşiyal ultrason rehberliğinde transbronşiyal iğne aspirasyonu (EBUS-TBİA) işleminin tanısal değeri araştırıldı.Çalışma planı: Nisan 2011 - Ocak 2013 tarihleri arasında EBUS-TBİA uygulanan 228 hasta (165 erkek, 63 kadın; ort. yaş 58.1 yıl; dağılım 22-84 yıl) retrospektif olarak incelendi. Tüm hastalara midazolam sedasyonu uygulandı. Lenf nodlarından alınan örneklerin tanısal doğrulaması cerrahi girişim veya klinik ve radyolojik takip ile yapıldı.Bul gu lar: Toplam 228 EBUS-TBİA işleminde 635 lenf noduna 1447 aspirasyon uygulandı. Hastaların %98.6'sında (225/228) örnekler histopatolojik olarak uygun idi. Histopatolojik incelemede 88 reaktif hiperplazi (%39), 82 neoplastik hastalık (%36), 39 granülomatöz hastalık (%17) (dört hasta tüberküloz ile uyumlu) ve malign hastalıktan şüphelenilen beş hasta (%2) saptandı. Hassasiyet, özgüllük, pozitif öngörü değeri, negatif öngörü değeri ve doğruluk oranları sırasıyla %91.7, %100, %100, %88.9 ve %95 idi. EBUS-TBİA işlemine bağlı mortalite gözlenmedi.So nuç: Bu çalışma mediastinal ve hiler lenf nodlarının değerlendirilmesinde EBUS-TBİA'nın güvenli ve tanısal değeri yüksek bir yöntem olduğuna işaret etmektedir.

Endobronşiyal ultrason rehberliğinde transbronşiyal iğne aspirasyonu: 228 hastanın retrospektif analizi

Background: This study aims to investigate the diagnostic value of endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) procedure in malign and benign diseases.Methods: Two hundred twenty-eight patients (165 males, 63 females; mean age 58.1 years; range 22 to 84 years) who were performed EBUS-TBNA between April 2011 and January 2013 were retrospectively analyzed. Midazolam sedation was applied in all patients. The diagnostic verification of the samples collected from lymph nodes was carried out by surgical intervention or clinical and radiological follow-up.Results: In a total of 228 EBUS-TBNA procedures, 1,447 aspirations were applied to 635 lymph nodes . In 98.6% of the patients (225/228), the samples were histopathologically appropriate. The histopathological examination identified 88 reactive hyperplasias (39%), 82 neoplastic diseases (36%), 39 granulomatous diseases (17%) (tuberculosis compatible in four patients), and five patients with suspicion of malignant diseases (2%). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rates were 91.7%, 100%, 100%, 88.9%, and 95%, respectively. No mortality was observed associated with EBUS-TBNA procedure.Conclusion: This study suggests that EBUS-TBNA is a reliable method with high diagnostic value in the evaluation of the mediastinal and hilar lymph nodes.

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