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Rapid On-site Evaluation of Transbronchial Aspirates in the Diagnosis of Hilar and Mediastinal Adenopathy
- Source :
- Chest. 139:395-401
- Publication Year :
- 2011
- Publisher :
- Elsevier BV, 2011.
-
Abstract
- Background Rapid on-site evaluation (ROSE) of transbronchial needle aspirates has long been used during flexible bronchoscopy, but its usefulness in the diagnosis of hilar and mediastinal adenopathy is controversial. The aim of the present study was to evaluate the extent to which ROSE can be valuable in patients undergoing transbronchial needle aspiration (TBNA) for the diagnosis of hilar and mediastinal adenopathy. Methods A total of 168 consecutive patients with enlarged lymph nodes were randomized to undergo TBNA with or without ROSE. The primary outcome measure of the study was the diagnostic yield of TBNA on a per-patient basis. Secondary outcome measures included the percentage of adequate specimens on a per-lymph node basis, the number of biopsy sites on a per-patient basis, and the complication rate of bronchoscopy on a per-patient basis. Results We found no significant difference between the TBNA group and the ROSE group in terms of diagnostic yield (75.3% vs 78.3%, respectively; P = .64), and percentage of adequate specimens (86.5% vs 78.4%, respectively; P = .11). The median (interquartile range) number of biopsy sites was significantly lower in the ROSE group (1 [1-2] vs 2 [1-2], respectively; P = .0005). The complication rate of bronchoscopy was significantly lower in patients undergoing on-site review (6% vs 20%; P = .01), whereas the complication rate of TBNA was similar among the study groups. Conclusions ROSE of transbronchial aspirates from hilar and mediastinal nodes enables avoidance of additional biopsy without loss in diagnostic yield and reduces the complication rate of bronchoscopy. Trial registry ClinicalTrials.gov; No.: NCT00915330; URL: www.clinicaltrials.gov
- Subjects :
- Pulmonary and Respiratory Medicine
medicine.medical_specialty
medicine.diagnostic_test
business.industry
Mediastinum
Critical Care and Intensive Care Medicine
medicine.disease
Surgery
law.invention
Lymphatic disease
medicine.anatomical_structure
Randomized controlled trial
Bronchoscopy
Interquartile range
law
Biopsy
medicine
Radiology
Cardiology and Cardiovascular Medicine
business
Prospective cohort study
Chi-squared distribution
Subjects
Details
- ISSN :
- 00123692
- Volume :
- 139
- Database :
- OpenAIRE
- Journal :
- Chest
- Accession number :
- edsair.doi...........cb0bb50e9cbadc71407eebfa43e9d74e