Diagnostic Yield and Safety of the 19-Gauge versus 22-Gauge Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Needle in Subjects with Sarcoidosis (GUESS).
Introduction: Observational data suggest that the 19-gauge (G) needle for endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) offers a higher diagnostic yield than the 22-G needle in sarcoidosis. No randomized trial has compared the yield of the two needles. Methods: We ra...
| Publicado en: | Respiration Vol. 103; no. 6; pp. 336 - 344 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Karger AG
2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=177720173&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 177720173 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00257931 NKR jtl: Respiration issn: 00257931 maglogo: N pubinfo: dt: 2024 vid: 103 iid: 6 pid: 2485 pub: Karger AG artinfo: ui: 177720173 177476602 177720173 177720173 10.1159/000538121 177720173 ppf: 336 ppct: 8 formats: tig: atl: Diagnostic Yield and Safety of the 19-Gauge versus 22-Gauge Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Needle in Subjects with Sarcoidosis (GUESS). aug: au: Dhooria, Sahajal Sehgal, Inderpaul Singh Prasad, Kuruswamy Thurai Muthu, Valliappan Dogra, Pooja Saini, Mandeep Gupta, Nalini Bal, Amanjit Aggarwal, Ashutosh Nath Agarwal, Ritesh affil: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India sug: subj: Sarcoidosis Diagnosis Sarcoidosis Pathology Biopsy, Needle Methods Bronchoscopy Needles Evaluation Needles Utilization Endosonography Methods Patient Safety Human Randomized Controlled Trials Random Assignment Visual Analog Scaling Punctures Evaluation Comparative Studies Outcome Assessment Adult Female Male Sensitivity and Specificity Anoxemia Adult: 19-44 years Female Male ab: Introduction: Observational data suggest that the 19-gauge (G) needle for endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) offers a higher diagnostic yield than the 22-G needle in sarcoidosis. No randomized trial has compared the yield of the two needles. Methods: We randomized consecutive subjects with suspected sarcoidosis and enlarged thoracic lymph nodes to undergo EBUS-TBNA with either the 19-G or the 22-G needle. We compared the study groups for diagnostic sensitivity (primary outcome) assessed by the yield of granulomas in subjects finally diagnosed with sarcoidosis. We also compared the sample adequacy, difficulty performing the needle puncture assessed on a visual analog scale (VAS), the subject's cough intensity on an operator-rated VAS, and procedure-related complications (secondary outcomes). Results: We randomized 150 (mean age, 43.0 years; 55% women) subjects and diagnosed sarcoidosis in 116 subjects. The diagnostic sensitivity of the 19-G needle (45/60, 75.0%) was not higher (p = 0.52) than the 22-G needle (39/56, 69.6%). We obtained adequate aspirates in 90.0% and 85.7% of subjects in the respective groups (p = 0.48). The operators had greater difficulty puncturing lymph nodes with the 19-G needle (p = 0.03), while the operator-assessed cough intensity was similar in the groups (p = 0.41). Transient hypoxemia was the only complication encountered during EBUS-TBNA (two subjects in either group). Conclusion: We did not find the 19-G needle superior to the 22-G in diagnostic sensitivity, specimen adequacy, or safety of EBUS-TBNA in sarcoidosis. Puncturing the lymph nodes was more difficult with the 19-G needle. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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