open access

Vol 89, No 3 (2021)
Research paper
Published online: 2021-06-30
Submitted: 2020-11-21
Accepted: 2021-04-12
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A randomized comparison of sample adequacy and diagnostic yield of various suction pressures in EBUS-TBNA

Anant Mohan1, Hariharan Iyer1, Karan Madan1, Vijay Hadda1, Saurabh Mittal1, Pawan Tiwari1, Deepali Jain1, Ravindra M Pandey1, Avneet Garg1, Randeep Guleria1
DOI: 10.5603/ARM.a2021.0054
·
Pubmed: 34196379
·
Adv Respir Med 2021;89(3):268-276.
Affiliations
  1. All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India

open access

Vol 89, No 3 (2021)
ORIGINAL PAPERS
Published online: 2021-06-30
Submitted: 2020-11-21
Accepted: 2021-04-12

Abstract

Introduction: The evidence for using vacuum suction during EBUS is sparse and the optimal suction pressure for obtaining adequate samples has not yet been determined. Our aim was to assess the influence of suction on the adequacy and diagnostic yield of EBUS-TBNA.
Material and methods: This single-center, prospective, randomized, non-inferiority trial assessed whether no-suction and 10 mL suction are inferior to 20 mL suction for adequacy and diagnostic yield of EBUS-TBNA aspirates.
Results: Three hundred twenty three lymph nodes were sampled using EBUS-TBNA. Baseline characteristics of lymph nodes were comparable in the three suction groups. The overall adequacy of EBUS-TBNA aspirates in the no-suction, 10 mL, and 20 mL suction was 90%, 83.49%, and 77.88%, respectively. The differences in adequacy were 12.1% (95% CI: 3.9–20.3) and 5.6% (95% CI: –3.3–14.5) for no-suction vs 20 mL, and 10 mL vs 20 mL suction, respectively. No-suction and 10 mL were not inferior to 20 mL suction in terms of sample adequacy. At a superiority margin of 3.92%, no-suction was superior to 20 mL suction in terms of sample adequacy (p < 0.05). The overall diagnostic yield was comparable (63.6%, 52.3%, and 57.7% in 0, 10 mL, and 20 mL, respectively; p-value was not significant). The proportion of aspirates which were predominantly bloody was similar (no-suction — 10.9%, 10 mL — 13.8%, 20 mL — 15.4%; p = 0.62).
Conclusions: EBUS-TBNA with or without the application of vacuum suction does not influence specimen adequacy and diagnostic yield.

Abstract

Introduction: The evidence for using vacuum suction during EBUS is sparse and the optimal suction pressure for obtaining adequate samples has not yet been determined. Our aim was to assess the influence of suction on the adequacy and diagnostic yield of EBUS-TBNA.
Material and methods: This single-center, prospective, randomized, non-inferiority trial assessed whether no-suction and 10 mL suction are inferior to 20 mL suction for adequacy and diagnostic yield of EBUS-TBNA aspirates.
Results: Three hundred twenty three lymph nodes were sampled using EBUS-TBNA. Baseline characteristics of lymph nodes were comparable in the three suction groups. The overall adequacy of EBUS-TBNA aspirates in the no-suction, 10 mL, and 20 mL suction was 90%, 83.49%, and 77.88%, respectively. The differences in adequacy were 12.1% (95% CI: 3.9–20.3) and 5.6% (95% CI: –3.3–14.5) for no-suction vs 20 mL, and 10 mL vs 20 mL suction, respectively. No-suction and 10 mL were not inferior to 20 mL suction in terms of sample adequacy. At a superiority margin of 3.92%, no-suction was superior to 20 mL suction in terms of sample adequacy (p < 0.05). The overall diagnostic yield was comparable (63.6%, 52.3%, and 57.7% in 0, 10 mL, and 20 mL, respectively; p-value was not significant). The proportion of aspirates which were predominantly bloody was similar (no-suction — 10.9%, 10 mL — 13.8%, 20 mL — 15.4%; p = 0.62).
Conclusions: EBUS-TBNA with or without the application of vacuum suction does not influence specimen adequacy and diagnostic yield.

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Keywords

EBUS-TBNA, diagnostic yield, sample adequacy, suction

About this article
Title

A randomized comparison of sample adequacy and diagnostic yield of various suction pressures in EBUS-TBNA

Journal

Advances in Respiratory Medicine

Issue

Vol 89, No 3 (2021)

Article type

Research paper

Pages

268-276

Published online

2021-06-30

DOI

10.5603/ARM.a2021.0054

Pubmed

34196379

Bibliographic record

Adv Respir Med 2021;89(3):268-276.

Keywords

EBUS-TBNA
diagnostic yield
sample adequacy
suction

Authors

Anant Mohan
Hariharan Iyer
Karan Madan
Vijay Hadda
Saurabh Mittal
Pawan Tiwari
Deepali Jain
Ravindra M Pandey
Avneet Garg
Randeep Guleria

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