title: Transbronchial needle aspiration through a guide sheath with endobronchial ultrasonography (GS-TBNA) for peripheral pulmonary lesions.
abstract: OBJECTIVE
  Although, endobronchial ultrasonography with a guide sheath is becoming a common procedure for the diagnosis of peripheral pulmonary lesions, there remain to be some inaccuracies in cases wherein the probe is located outside the lesion. We tested whether adding transbronchial needle aspiration through a guide sheath to the conventional technique increases efficacy for diagnosing peripheral pulmonary lesions.
  
  
  METHODS
  We performed transbronchial needle aspiration through a guide sheath for 37 subjects with peripheral pulmonary lesions between September 2012 and April 2013. The devices used were as follows (all Olympus Ltd., Tokyo, Japan): 1T-260 or LF-TP bronchoscope, K203 guide sheath kit and NA-1C-1 needle apparatus, customized by cutting the guide sheath 30 mm from the proximal end to fit well with the needle.
  
  
  RESULTS
  The endobronchial ultrasound probe was located within the lesion in 21 cases (56.8%) and outside in 16 cases (43.2%). Overall accuracy was 86.5 percent; 90.5% in "within" cases compared to 81.3% in "outside" cases with no significant difference (P = 0.42). Pneumothorax occurred in 2 cases and pneumonia in 1 case.
  
  
  CONCLUSIONS
  Transbronchial needle aspiration through a guide sheath is an effective and safe diagnostic procedure for peripheral pulmonary lesions, especially when the guide sheath is outside the lesion.
authors.affiliation: Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Motohisa
authors.initials: M
authors.lastname: Takai
authors.forename: Takehiro
authors.initials: T
authors.lastname: Izumo
authors.forename: Christine
authors.initials: C
authors.lastname: Chavez
authors.forename: Takaaki
authors.initials: T
authors.lastname: Tsuchida
authors.forename: Shinji
authors.initials: S
authors.lastname: Sasada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020680:Bronchoscopes; D001999:Bronchoscopy / Q000295:instrumentation*; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology*; D008171:Lung Diseases / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009339:Needles; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies