Technical aspects of endobronchial ultrasound-guided transbronchial needle aspiration: CHEST guideline and expert panel report

Background - Endobronchial ultrasound (EBUS) was introduced in the last decade, enabling real-time guidance of transbronchial needle aspiration (TBNA) of mediastinal and hilar structures and parabronchial lung masses. The many publications produced about EBUS-TBNA have led to a better understanding...

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Hauptverfasser: Wahidi, Momen M. (VerfasserIn) , Herth, Felix (VerfasserIn) , Yasufuku, Kazuhiro (VerfasserIn) , Shepherd, Ray Wesley (VerfasserIn) , Yarmus, Lonny (VerfasserIn) , Chawla, Mohit (VerfasserIn) , Lamb, Carla (VerfasserIn) , Casey, Kenneth R. (VerfasserIn) , Patel, Sheena (VerfasserIn) , Silvestri, Gerard A. (VerfasserIn) , Feller-Kopman, David J. (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: [March 2016]
In: Chest
Year: 2016, Jahrgang: 149, Heft: 3, Pages: 816-835
ISSN:1931-3543
DOI:10.1378/chest.15-1216
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1378/chest.15-1216
Verlag, lizenzpflichtig, Volltext: http://www.sciencedirect.com/science/article/pii/S0012369215000306
Volltext
Verfasserangaben:Momen M. Wahidi, Felix Herth, Kazuhiro Yasufuku, Ray Wesley Shepherd, Lonny Yarmus, Mohit Chawla, Carla Lamb, Kenneth R. Casey, Sheena Patel, Gerard A. Silvestri, and David J. Feller-Kopman

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520 |a Background - Endobronchial ultrasound (EBUS) was introduced in the last decade, enabling real-time guidance of transbronchial needle aspiration (TBNA) of mediastinal and hilar structures and parabronchial lung masses. The many publications produced about EBUS-TBNA have led to a better understanding of the performance characteristics of this procedure. The goal of this document was to examine the current literature on the technical aspects of EBUS-TBNA as they relate to patient, technology, and proceduralist factors to provide evidence-based and expert guidance to clinicians. - Methods - Rigorous methodology has been applied to provide a trustworthy evidence-based guideline and expert panel report. A group of approved panelists developed key clinical questions by using the PICO (population, intervention, comparator, and outcome) format that addressed specific topics on the technical aspects of EBUS-TBNA. MEDLINE (via PubMed) and the Cochrane Library were systematically searched for relevant literature, which was supplemented by manual searches. References were screened for inclusion, and well-recognized document evaluation tools were used to assess the quality of included studies, to extract meaningful data, and to grade the level of evidence to support each recommendation or suggestion. - Results - Our systematic review and critical analysis of the literature on 15 PICO questions related to the technical aspects of EBUS-TBNA resulted in 12 statements: 7 evidence-based graded recommendations and 5 ungraded consensus-based statements. Three questions did not have sufficient evidence to generate a statement. - Conclusions - Evidence on the technical aspects of EBUS-TBNA varies in strength but is satisfactory in certain areas to guide clinicians on the best conditions to perform EBUS-guided tissue sampling. Additional research is needed to enhance our knowledge regarding the optimal performance of this effective procedure. 
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