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Ten-year experience of transbronchial endosonography in single center

https://doi.org/10.35401/2500-0268-2021-22-2-6-13

Abstract

Objective Transbronchial endosonography (EBUS) is a relatively new method for diagnosing of the pathological condition of the thoracic organs. Analysis of 10 years of our experience in the use of transbronchial endosonography in a specialized center.

Material and Methods During the period from April 2010 to April 2020, 756 transbronchial endosonographies were conducted on 756 patients. The studies were carried out for various indications: 1) Group 1 (483) – transbronchial puncture of the lymph nodes in order to obtain morphological confirmation of the etiology; 2) Group 2 (260) – staging of suspected or verified lung cancer to determine the descriptor N; 3) Group 3 (13) – a study that ended only with obtaining an endosonographic image. All patients underwent transbronchial endosonography using the special ultrasound bronchoscope EB-1970UK (Pentax Corp.) and the ultrasound scanner EUB 5000 Plus G OB/GYN – Vascular Ultrasound (HITACHI Corp.).

Results General information content was 78%; verification of mediastinal lymphadenopathy was 72% (57, 79, 58% for smears, cytoblocks and smears + cytoblocks, cytoblocks vs smears + cytoblocks, p < 0.05). Verification of local changes in the mediastinum – 66%; verification of peribronchial tumor – 87%. Lung cancer staging – 87% (82, 88, 86% for smears, cytoblocks vs smears + cytoblocks, respectively, р > 0.05)

Conclusion Тhe diagnostic utility of EBUS for the verification of mediastinal lymphadenopathy can range from 37,5 to 83% and rise with increasing experience for all persons involved. The use of cytoblocks showed the best results. The diagnostic utility of staging varies from 60 to 100% and does not depend on the method of processing the aspiration material.

About the Authors

I. V. Vasilev
St. Petersburg State Research Institute of Phthisiopulmonology
Russian Federation

Igor V. Vasilev, Cand. of Sci. (Med.), Thoracic Surgeon, Leading Researcher, Head of Interventional Pulmonology Discipline

Ligovsky Prospect, 2–4, St. Petersburg, 191036



I. A. Zaitcev
St. Petersburg State Research Institute of Phthisiopulmonology
Russian Federation

Ivan A. Zaitcev, Thoracic Surgeon, Oncologist

St. Petersburg



G. G. Kudriashov
St. Petersburg State Research Institute of Phthisiopulmonology
Russian Federation

Grigory G. Kudriashov, Cand. of Sci. (Med.), Senior Staff Scientist, Thoracic Surgeon

St. Petersburg



V. F. Lee
St. Petersburg State Research Institute of Phthisiopulmonology
Russian Federation

Vladimir F. Lee, Head of Resuscitation Department

St. Petersburg



T. A. Novitskaya
St. Petersburg State Research Institute of Phthisiopulmonology; St. Petersburg State University
Russian Federation

Tatiana A. Novitskaya, Cand. of Sci. (Med.), Head of Pathomorphology Department, St. Petersburg State Research Institute of Phthisiopulmonology; Associate Professor, Pathology Department of the Medical Faculty, St. Petersburg State University

St. Petersburg



E. G. Sokolovich
St. Petersburg State Research Institute of Phthisiopulmonology; St. Petersburg State University
Russian Federation

Evgeny G. Sokolovich, Dr. of Sci. (Med.), Professor, Deputy Director for Scientific Work, St. Petersburg State Research Institute of Phthisiopulmonology; Professor, Hospital Surgery Department, St. Petersburg State University

St. Petersburg



P. K. Yablonskiy
St. Petersburg State Research Institute of Phthisiopulmonology; St. Petersburg State University
Russian Federation

Petr K. Yablonskiy, Dr. of Sci. (Med.), Professor, Director of St. Petersburg State Research Institute of Phthisiopulmonology; Dean of the Faculty of Medicine, Head of Hospital Surgery Department, St. Petersburg State University

St. Petersburg



References

1. Herth F, Becker HD, Manegold C, Drings P. Endobronchial ultrasound (EBUS) – assessment of a new diagnostic tool in bronchoscopy for staging of lung cancer. Onkologie. 2001;24(2):151–54. PMID: 11441295. https://doi.org/10.1159/000050303

2. Porhanov VA, Sel'vashchuk AP, Polyakov IS, et al. Possibilities of ultrasound bronchoscopy. New technologies in cardiothoracic and oncosurgery: Krasnodar – Ol'ginka Conference Proceedings. 2007. (In Russ.)

3. Vasilev IV, Yakushenko NS, Ilyashuk EA, et al. Mediastinal lymph node biopsy under the control of EBUS-TBNA in the differential diagnosis of mediastinal lymphadenopathies. Tuberculosis and Lung Diseases. 2011;88(4):79. (In Russ.)

4. Kudryashov GG, Vasil'ev IV, Zaitsev IA, et al. EBUS-TBNA in the differential diagnosis of tuberculous lymphadenitis in patients with mediastinal lymphadenopathy. Medical Alliance. 2017;2:35– 42. (In Russ.)

5. Rusch VW, Asamura H, Watanabe H, et al. The IASLC lung cancer staging project: a proposal for a new international lymph node map in the forthcoming seventh edition of the TNM classification for lung cancer. J Thorac Oncol. 2009;4(5):568–577. PMID: 19357537. https://doi.org/10.1097/jto.0b013e3181a0d82e

6. Medford ARL, Agrawal S, Free CM, Bennett JA. A prospective study of conventional transbronchial needle aspiration: performance and cost utility. Respiration. 2010;79(6):482–489. PMID: 20110643. https://doi.org/10.1159/000277931

7. Trisolini R, Patelli M, Gasparini S. While waiting to buy a ferrari, do not leave your current car in the garage! Respiration. 2010;79(6):452–453. PMID: 20160431. https://doi.org/10.1159/000287250

8. Gasparini S, Bonifazi M. Rapid on-site cytological evaluation of transbronchial needle aspiration: Why not? Lung India. 2014;31(3):203–204. PMID: 25125802. PMCID: PMC4129587. https://doi.org/10.4103/0970-2113.135751

9. Rosso L, Ferrero S, Mendogni P, et al. Tenyear experience with endobronchial ultrasound-guided transbronchial needle aspiration: single center results in mediastinal diagnostic and staging. J Thorac Dis. 2017;9(5):363–369. PMID: 28603646. PMCID: PMC5459875. https://doi.org/10.21037/jtd.2017.03.115

10. Chrysikos S, Karampitsakos T, Zervas E, et al. Thoracic endosonography (EBUS/EUS-b) in the diagnosis of different intrathoracic diseases: A 4-year experience at a single-centre in Greece. Int J Clin Pract. 2020;19:e13684. PMID: 32813909. https://doi.org/10.1111/ijcp.13684

11. Hergott CA, MacEachern P, Stather DR, Tremblay A. Repair costs for endobronchial ultrasound bronchoscopes. J Bronchology Interv Pulmonol. 2010;17(3):223–227. PMID: 23168887. https://doi.org/10.1097/lbr.0b013e3181e77280

12. Yasufuku K, Chiyo M, Sekine Y, et al. Real-time endobronchial ultrasound-guided transbronchial needle aspiration of mediastinal and hilar lymph nodes. Chest. 2004;126(1):122– 128. PMID: 15249452. https://doi.org/10.1378/chest.126.1.122

13. Guarize J, Casiraghi M, Donghi S, et al. Endobronchial ultrasound transbronchial needle aspiration in thoracic diseases: much more than mediastinal staging. Can Respir J. 2018;2018:4269798. PMID: 29686741. PMCID: PMC5857308. https://doi.org/10.1155/2018/4269798

14. Gahlot T, Parakh U, Verma K, Bhalotra B, Jain N. Endobronchial ultrasound-guided transbronchial needle aspiration in diagnosing mediastinal lymphadenopathy. Lung India. 2017;34(3):241–246. PMID: 28474649. PMCID: PMC5427751. https://doi.org/10.4103/0970-2113.205339

15. Madan K, Dhungana A, Mohan A, et al. Conventional transbronchial needle aspiration versus endobronchial ultrasoundguided transbronchial needle aspiration, with or without rapid on-site evaluation, for the diagnosis of sarcoidosis: a randomized controlled trial. J Bronchology Interv Pulmonol. 2017;24:48–58. PMID: 27984385. https://doi.org/10.1097/lbr.0000000000000339

16. Kheir F, Alokla K, Myers L, Palomino J. Endobronchial ultrasound-transbronchial needle aspiration of mediastinal and hilar lymphadenopathy learning curve. Am J Ther. 2016;23(4):e1016-e1019. PMID: 24621644. PMCID: PMC4160423. https://doi.org/10.1097/mjt.0000000000000050

17. Zhu J, Zhang H, Ni J, et al. Endobronchial ultrasoundguided transbronchial needle aspiration for diagnosing mediastinal lymphadenectasis: a cohort study from a single center. Clin Respir J. 2017;11(2):159–167. PMID: 25918974. https://doi.org/10.1111/crj.12317

18. Sharples LD, Jackson C, Wheaton E, et al. Clinical effectiveness and cost- effectiveness of endobronchial and endoscopic ultrasound relative to surgical staging in potentially resectable lung cancer: results from the ASTER randomised controlled trial. Health Technol Assess. 2012;16(18). PMID: 22472180. https://doi.org/10.3310/hta16180

19. Vilmann P, Clementsen P, Colella S, et al. Combined endobronchial and esophageal endosonography for the diagnosis and staging of lung cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline, in cooperation with the European Respiratory Society (ERS) and the European Society of Thoracic Surgeons (ESTS). Endoscopy. 2015;47(6):545–559. PMID: 26030890. https://doi.org/10.1055/s-0034-1392040

20. Skorokhod AA, Kozak AR, Vasilev IV, et al. Endobronchial ultrasonography with aspiration biopsy of the mediastinal lymph nodes and video-assisted mediastinoscopic lymphadenectomy in detecting "occult" N2-N3 metastasis in patients with non-small cell lung cancer. Medical Alliance. 2020;8(1):43–53. (In Russ.). https://doi.org/10.36422/23076348-2020-8-1-43-53

21. Rotolo N, Cattoni M, Crosta G, et al. Comparison of multiple techniques for endobronchial ultrasoundtransbronchial needle aspiration specimen preparation in a single institution experience. J Thorac Dis. 2017;9(5):S381–S385. PMID: 28603649. PMCID: PMC5459870. https://doi.org/10.21037/jtd.2017.04.25

22. van der Heijden EHFM, Casal RF, Trisolini R, et al. Guideline for the acquisition and preparation of conventional and endobronchial ultrasound-guided transbronchial needle aspiration specimens for the diagnosis and molecular testing of patients with known or suspected lung cancer. Respiration. 2014;88(6):500– 517. PMID: 25377908. https://doi.org/10.1159/000368857


Review

For citations:


Vasilev I.V., Zaitcev I.A., Kudriashov G.G., Lee V.F., Novitskaya T.A., Sokolovich E.G., Yablonskiy P.K. Ten-year experience of transbronchial endosonography in single center. Innovative Medicine of Kuban. 2021;(2):6-13. (In Russ.) https://doi.org/10.35401/2500-0268-2021-22-2-6-13

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