Endobronchial Ultrasound

and
Transbronchial Needle Aspiration (EBUS-TBNA)

Dr Upul Pathirana (Registrar)

Dr Jaymin Morjaria (Consultant Respiratory Physician)
Harefield Hospital
 Background
• Mediastinal and hilar lymphadenopathy detected on imaging
needs tissue sampling for cytology/ histology and
microbiology for the final diagnosis

• Mediastinoscopy with lymph node sampling is considered to

be the gold standard. EBUS-TBNA has replaced
mediastinoscopy which is a more invasive and complicated
procedure.
 Timeframe (01/01/2016 – 31/12/2017) & distribution

2016 Month Number of cases 2017 Month Number of cases

January 6 January 5
February 4 February 8
March 3 March 10
April 9 April 2
May 7 May 8
June 17 June 10
July 8 July 1
August 6 August 13
September 9 September 6
October 11 October 8
November 8 November 8
December 6 December 3
Total 94 Total 82
 Lymph Node Hit rate

outcome 2016 2017

Positive lymphoid tissue 88 77

Inadequate sample 6 5

Total number 94 82

Lymph Node Hit rate 93.6% 93.9%

 Sampled lymph node stations

2016 2017
Lymph Node Station Lymph Node Stations
Sampled Sampled
2
2R 2R
17 12 6
4R 4R
26 50 31 50
4L 4L
3 1
7 7
11
15 10R 10R
31 10L 22 10L
55 11R 73 11R
11L 11L
 Anesthesia and sedation

Anesthesia Number of cases

Sedation 152

GA 24

Total 176
 Complications

• Minor bleeding – (1)

• Decayed tooth broken (1)
• Hypertensive and tachycardia (1)
• Extensive gag reflex (1)
• Blockage of scope (1)
 Conclusions
• EBUS is a safe procedure

• The lymph node Hit Rate is high however is

dependent on the administrator and
teamwork.
Thank you