Diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal staging in lung cancer*

OBJECTIVE: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive diagnostic test with a high diagnostic yield for suspicious central pulmonary lesions and for mediastinal lymph node staging. The main objective of this study was to describe the diagnostic yield of EBUS-TBNA for mediastinal lymph node staging in patients with suspected lung cancer. METHODS: Prospective study of patients undergoing EBUS-TBNA for diagnosis. Patients ≥ 18 years of age were recruited between July of 2010 and August of 2013. We recorded demographic variables, radiological characteristics provided by axial CT of the chest, location of the lesion in the mediastinum as per the International Association for the Study of Lung Cancer classification, and definitive diagnostic result (EBUS with a diagnostic biopsy or a definitive diagnostic method). RESULTS: Our analysis included 354 biopsies, from 145 patients. Of those 145 patients, 54.48% were male. The mean age was 63.75 years. The mean lymph node size was 15.03 mm, and 90 lymph nodes were smaller than 10.0 mm. The EBUS-TBNA method showed a sensitivity of 91.17%, a specificity of 100.0%, and a negative predictive value of 92.9%. The most common histological diagnosis was adenocarcinoma. CONCLUSIONS: EBUS-TBNA is a diagnostic tool that yields satisfactory results in the staging of neoplastic mediastinal lesions

Recommendations for performing interventions during the COVID-19 pandemic

El coronavirus (SARS-CoV-2), es un agente etiológico causante de neumonía viral emergente, comúnmente llamado COVID-19. Este microorganismo produce cuadros de neumonía asociado a falla ventilatoria, principalmente por el desarrollo de distrés respiratorio agudo. Dentro de las características de este virus, se encuentra la alta capacidad de contagio, lo que se asocia a una tasa de infecciones asociadas a la atención en salud con un rango de 20%-30%. En este escenario, los procedimientos asociados a intervenciones de la vía aérea poseen un riesgo aumentado de contagio y de exposición del personal de salud por la generación de aerosoles respiratorios. Es importante establecer que procedimientos son electivos, prioritarios y urgentes. Esto reducirá el riesgo de contagio en el personal, así como el aumento de nuevos casos de COVID-19. El objetivo de este documento es entregar recomendaciones para disminuir el contagio de SARS-CoV-2 en relación a procedimientos que impliquen intervenciones pulmonares.Q4Q4Coronavirus infection (SARS-CoV-2), is a pandemic disease declared by the World Health Organization (WHO). This disease reports a high risk of contagion, especially by the transmission of aerosols in health care workers. In this scenario, aerosol exposure is increased in various procedures related to the airway, lungs, and pleural space. For this reason, it is important to have recommendations that reduce the risk of exposure and infection with COVID-19. In this document, a team of international specialists in interventional pulmonology elaborated a series of recommendations, based on the available evidence to define the risk stratification, diagnostic methods and technical considerations on procedures such as bronchoscopy, tracheostomy, and pleural procedures among others. As well as the precautions to reduce the risk of contagion when carrying out pulmonary interventions.https://orcid.org/0000-0003-3975-2835Revista Internacional - IndexadaBN