Document Detail


Rapid on-site evaluation of transbronchial aspirates in the diagnosis of hilar and mediastinal adenopathy: a randomized trial.
MedLine Citation:
PMID:  21030491     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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
Authors:
Rocco Trisolini; Alessandra Cancellieri; Carmine Tinelli; Daniela Paioli; Luigia Scudeller; Gian Piero Casadei; Sergio Forti Parri; Vanina Livi; Arrigo Bondi; Maurizio Boaron; Marco Patelli
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2010-10-28
Journal Detail:
Title:  Chest     Volume:  139     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-02     Completed Date:  2011-03-17     Revised Date:  2012-09-10    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  395-401     Citation Subset:  AIM; IM    
Affiliation:
Thoracic Endoscopy and Pulmonology Unit, Maggiore Hospital, Largo B. Nigrisoli 2, 40133 Bologna, Italy. rocco.trisolini@ausl.bologna.it
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00915330
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MeSH Terms
Descriptor/Qualifier:
Biopsy, Needle / methods*
Bronchoscopy
Chi-Square Distribution
Female
Humans
Lymphatic Diseases / diagnosis*,  pathology
Male
Mediastinum / pathology*
Middle Aged
Prospective Studies
Statistics, Nonparametric
Comments/Corrections
Comment In:
Chest. 2011 Aug;140(2):559-60; author reply 560   [PMID:  21813541 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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