[Clinical usefulness and cost-effectiveness of transbronchial needle aspiration for the diagnosis of mediastinal adenopathy].
Transbronchial needle aspiration (TBNA) of mediastinal or hilar enlarged lymph nodes is a useful and safe technique. Nevertheless, its use has not become widespread, and the necessity of a specific training to obtain good results has been reported. In order to evaluate the clinical usefulness and cost-effectiveness of TBNA in inexperienced brochoscopists in this technique, a prospective study was conducted of this technique used in all patients with a chest CT with paratracheobronchial lymph nodes larger than 10 mm who had a fiberbronchoscopy ordered. TBNA was performed in 66 lymph node staging in 59 patients. In 76% of cases adequate specimens were obtaned, and a cytohistologic diagnosis was established in 59%. In 44% of patients, TBNA avoided other more invasive diagnostic procedures. Had TBNA not been performed, cost was estimated to have been at least five times higher. We conclude that TBNA could be a useful cost-effective technique in inexperienced teams.
Fernández Villar
J A
JA
Servicio de Neumología, Complexo Hospitalario Xeral-Cíes, Vigo. jfv01po@nacom.es
Iglesias Río
F
F
Barreiro Barreiro
J M
JM
Mosteiro Añón
M M
MM
Vilariño Pombo
C
C
Torres Durán
M L
ML
Otero Varela
J
J
Piñeiro Amigo
L
L
D001707:Biopsy, Needle / Q000191:economics; D001980:Bronchi; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000473:pathology*; D008206:Lymphatic Diseases / Q000473:pathology*; D008297:Male; D020707:Mediastinoscopes; D008482:Mediastinum; D008875:Middle Aged; D011446:Prospective Studies