title: Usefulness of high suction pressure for sufficient tissue collection during endobronchial ultrasound guided transbronchial needle aspiration.
abstract: BACKGROUND
  The optimal suction pressure during endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) remains to be determined. The aim of this study was to compare suction pressures for performance in collecting sufficient tissue specimens from mediastinal and hilar lymph nodes during EBUS-TBNA.
  
  
  METHODS
  Retrospective analysis of consecutive patients with mediastinal and hilar lymphadenopathy who underwent EBUS-TBNA over a 3-year period. Results from patients who underwent EBUS-TBNA using a dedicated 20-mL VacLoc (Merit Medical Systems, Inc, South Jordan, UT) syringe (conventional method, group C) were compared with results from patients in whom a disposable 30-mL syringe (high pressure group, group H) was used. The yield for sufficient histologic specimen retrieval and amount of tissue obtained were compared between the 2 groups.
  
  
  RESULTS
  Of 178 patients who underwent EBUS-TBNA, 131 had lung cancer confirmed by EBUS-TBNA: 35 in group C and 96 in group H. There were 7 patients in group C and 6 in group H who received final diagnoses by cytology alone. There were 28 in group C and 90 in group H who were diagnosed by both cytology and histology. There was a statistically significant difference between the groups in terms of the rate of sufficient sampling for histological specimens (p = 0.04). The H group revealed a tissue area approximately twice that of the C group (p = 0.003). There were no major procedure-related complications in either group.
  
  
  CONCLUSIONS
  Higher suction pressures with larger syringe volumes during EBUS-TBNA may be useful for safely collecting sufficient tissue specimens.
authors: Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Osaka, Japan.
authors: Takayuki
authors: T
authors: Shiroyama
authors: Norio
authors: N
authors: Okamoto
authors: Hidekazu
authors: H
authors: Suzuki
authors: Motohiro
authors: M
authors: Tamiya
authors: Tadahiro
authors: T
authors: Yamadori
authors: Naoko
authors: N
authors: Morishita
authors: Tomoyuki
authors: T
authors: Otsuka
authors: Satomu
authors: S
authors: Morita
authors: Kanako
authors: K
authors: Kurata
authors: Akira
authors: A
authors: Okimura
authors: Kunimitsu
authors: K
authors: Kawahara
authors: Shinji
authors: S
authors: Sasada
authors: Tomonori
authors: T
authors: Hirashima
authors: Ichiro
authors: I
authors: Kawase
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008206:Lymphatic Diseases / Q000473:pathology*; D008297:Male; D008477:Mediastinal Diseases / Q000473:pathology*; D008482:Mediastinum / Q000473:pathology*; D008875:Middle Aged; D012189:Retrospective Studies