title: Complications of Convex-Probe Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Multi-Center Retrospective Study.
abstract: BACKGROUND
  Infrequent serious complications of convex-probe endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) have been reported. The aim of this study was to assess serious complications related to convex-probe EBUS-TBNA and to determine the complication rate in a large group of subjects.
  
  
  METHODS
  In this retrospective study, a 15-item questionnaire on features of cases with EBUS-TBNA complications was sent to experienced bronchoscopists performing convex-probe EBUS-TBNA at 3 pulmonary centers. The medical records were then reviewed by these bronchoscopists to complete the questionnaire. Hemorrhage responsive to topical treatment, temporary laryngospasm/bronchospasm, transient oxygen desaturation, and fever lasting <24 h were excluded. Only complications requiring further treatment/intervention were considered serious. The rate of serious complications was calculated from the obtained data.
  
  
  RESULTS
  In a total of 3,123 cases within a 5-y period, EBUS-TBNA was performed for staging lung cancer in 15.8%, diagnosis in 67.5%, and diagnosis and staging in 16.3%. Of the 3,123, 11.6% had parenchymal lesions adjacent to major airways. EBUS-TBNA was performed 11,753 times (3.76/case) at 6,115 lymph node stations and lesions (1.92/station or lesion). Five serious complications were recorded (0.16%): fever lasting >24 h, infection of bronchogenic cyst, mediastinal abscess, pericarditis, and pneumomediastinitis with empyema, each in one case. Four complications occurred in cases diagnosed with benign disease by EBUS-TBNA. All complications were treated with broad-spectrum antibiotics. Four subjects were hospitalized for 21.7 ± 20.7 d.
  
  
  CONCLUSIONS
  Convex-probe EBUS-TBNA is a safe method in general. However, serious complications, including infections, can be encountered rarely. All precautions should be taken for complications before and during the procedure.
authors.affiliation: Department of Pulmonary Diseases, Dr. Lütfi Kırdar Kartal Training and Research Hospital, Istanbul, Turkey.
authors.forename: Benan
authors.initials: B
authors.lastname: Çağlayan
authors.affiliation: Atatürk Chest Diseases and Thoracic Surgery Education and Research Hospital, Interventional Pulmonology, Ankara, Turkey.
authors.forename: Aydın
authors.initials: A
authors.lastname: Yılmaz
authors.affiliation: Department of Pulmonary Diseases, Izmir Dr. Suat Seren Training and Research Hospital for Thoracic Medicine and Surgery, Izmir, Turkey.
authors.forename: Semra
authors.initials: S
authors.lastname: Bilaçeroğlu
authors.affiliation: Department of Pulmonary Diseases, Dr. Lütfi Kırdar Kartal Training and Research Hospital, Istanbul, Turkey. sevdasener2@yahoo.com.
authors.forename: Sevda Şener
authors.initials: SŞ
authors.lastname: Cömert
authors.affiliation: Atatürk Chest Diseases and Thoracic Surgery Education and Research Hospital, Interventional Pulmonology, Ankara, Turkey.
authors.forename: Nilgün Y
authors.initials: NY
authors.lastname: Demirci
authors.affiliation: Department of Pulmonary Diseases, Dr. Lütfi Kırdar Kartal Training and Research Hospital, Istanbul, Turkey.
authors.forename: Banu
authors.initials: B
authors.lastname: Salepçi
mesh_terms: D000038:Abscess / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001980:Bronchi / Q000000981:diagnostic imaging / Q000601:surgery; D001994:Bronchogenic Cyst / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D020680:Bronchoscopes / Q000009:adverse effects*; D001999:Bronchoscopy / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D016724:Empyema, Pleural / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000009:adverse effects* / Q000379:methods; D004867:Equipment Design; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008477:Mediastinal Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D008875:Middle Aged; D010493:Pericarditis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D011183:Postoperative Complications / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: complications; endobronchial ultrasonography; transbronchial needle aspiration