title: Utility of conventional transbronchial needle aspiration with rapid on-site evaluation (c-TBNA-ROSE) at a tertiary care center with endobronchial ultrasound (EBUS) facility.
abstract: BACKGROUND
  Conventional transbronchial needle aspiration (c-TBNA) is an underutilized bronchoscopic modality. Endobronchial ultrasound (EBUS) guided-TBNA though efficacious is an expensive modality, facilities of which are available at only limited centers. c-TBNA is cost-effective and has potential for wide utilization especially in resource-limited settings. Rapid on-site evaluation (ROSE) improves the yield of c-TBNA.
  
  
  METHODS
  A retrospective review of the bronchoscopy records (May 2012 to July 2014) was performed. The patients who underwent c-TBNA with ROSE were included in the study and their clinical details were extracted. Convex probe EBUS-TBNA was being regularly performed during the study period by the operators performing c-TBNA.
  
  
  RESULTS
  c-TBNA with ROSE was performed in 41 patients with mean age of 42.4 (16.2) years. The most frequently sampled node stations (>90% patients) were the subcarinal and lower right paratracheal. Representative samples could be obtained in 33 out of the 41 patients (80.4%). c-TBNA was diagnostic in 32 [tuberculosis (TB)-8, sarcoidosis-9, and malignancy-15] patients out of the 41 patients. The overall diagnostic yield (sensitivity) of c-TBNA with ROSE was 78%. Mean procedure duration was 18.4 (3.1) min and there were no procedural complications.
  
  
  CONCLUSIONS
  c-TBNA with ROSE is a safe, efficacious, and cost-effective bronchoscopic modality. When it was performed by operators routinely performing EBUS-TBNA, diagnostic yields similar to that of EBUS-TBNA can be obtained. Even at the centers where EBUS facilities are available, c-TBNA should be routinely performed.
authors.affiliation: Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors.forename: Neha Kawatra
authors.initials: NK
authors.lastname: Madan
authors.affiliation: Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors.forename: Karan
authors.initials: K
authors.lastname: Madan
authors.affiliation: Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors.forename: Deepali
authors.initials: D
authors.lastname: Jain
authors.affiliation: Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors.forename: Ritika
authors.initials: R
authors.lastname: Walia
authors.affiliation: Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors.forename: Anant
authors.initials: A
authors.lastname: Mohan
authors.affiliation: Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors.forename: Vijay
authors.initials: V
authors.lastname: Hadda
authors.affiliation: Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Mathur
authors.affiliation: Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors.forename: Venkateswaran K
authors.initials: VK
authors.lastname: Iyer
authors.affiliation: Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors.forename: Gopi C
authors.initials: GC
authors.lastname: Khilnani
authors.affiliation: Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors.forename: Randeep
authors.initials: R
authors.lastname: Guleria
keywords: Bronchoscopy; lung cancer; sarcoidosis; transbronchial needle aspiration