İntratorasik lezyonların tanısında geleneksel transbronşiyal iğne aspirasyonu klinik sonuçlarımız
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Dosyalar
Tarih
2020
Yazarlar
Dergi Başlığı
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Yayıncı
Trakya Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Transbronşiyal iğne aspirasyonu, mediastinal lenf nodlarının ve endobronşiyal, submukozal, peribronşiyal lezyonların örneklenmesinde kullanılan değerli bir tanı yöntemidir. Çalışmamızın amacı, transbronşiyal iğne aspirasyonu işleminin akciğer ve mediastinal lezyonlarda tanısal değerini ortaya koymaktır. 2011-2018 yılları arasında Trakya Üniversitesi Tıp Fakültesi Göğüs Hastalıkları biriminde transbronşiyal iğne aspirasyonu işlemi yapılmış olup sonuçlarına ulaşılabilen tüm hastalar değerlendirildi. İşlem öncesinde her hastanın mutlaka görüntülemesi yapıldı, işlem için onamı alındı. İşlem esnasında Olympus BF-1T160 (OLYMPUS OPTICAL Co, LTD. Tokyo, Japan) , Fujinon EB-530T (FUJIFILM Corporation Tokyo, Japan) ve Pentax EB1975K (HOYA Corporation Tokyo, Japan) cihazları ile 19-21 gauge ve/veya 22 gauge Wang (CONMED® Corporation NY/USA, Matek® Medical Equipment Co. Ankara/TR) iğnesi kullanıldı. Belirtilen yıllar arasında işlem yapılan, sonuçlarına ve takiplerine ulaşılabilen 272 hasta analiz edildi. 272 hastanın 154 (%56,61) tanesine yapılan işlem tanısal iken, 118 (%43,38) tanesine yapılan işlem tanısal olmamıştı. Transbronşiyal iğne aspirasyonu işleminin duyarlılık oranı %56,13, özgüllük %100, tanısallık %56,61, negatif prediktif değer %2,47 ve pozitif prediktif değer %100 olarak bulunmuştur. En yüksek tanısal verimlilik akciğer kanseri hastalarında saptanmıştır. Submukozal/peribronşiyal lezyonu olan hastalarda transbronşiyal iğne aspirasyonu işleminin tanısallığı (%50) ile forseps biyopsi işleminin tanısallığı (%26) karşılaştırıldığında aralarında anlamlı fark olduğu saptanmıştır. (p=0,013). Analiz edilen toplam 272 hastanın 6’sında (%2,20) işlem esnasında minör komplikasyon izlenmiştir. Transbronşiyal iğne aspirasyonu işlemi mediastinal lenfadenopati ve peribronşiyal lezyonlar gibi intratorasik lezyonlarda tanısal verimliliği yüksek bir yöntemdir. Özellikle submukozal/peribronşiyal lezyonlarda forseps biyopsiye göre tanısal verimliliğinin daha yüksek olduğu görülmekte olup birlikte veya öncelikle tercih edilmesi gerektiği düşüncesindeyiz. Ayrıca yüksek tanısallık ve düşük komplikasyon oranları olan bir yöntem olup intratorasik lezyonlarda diğer invaziv prosedürlerden önce güvenli bir yöntem olarak akılda tutulmalıdır.
Transbronchial needle aspiration is a valuable diagnostic method used in sampling mediastinal lymph nodes and endobronchial, submucosal, peribronchial lesions. The aim of our study was to determine the diagnostic value of transbronchial needle aspiration in lung and mediastinal lesions. Between 2011 and 2018, transbronchial needle aspiration was performed in the Chest Diseases unit of the Faculty of Medicine of Trakya University and all the patients whose results could be reached were evaluated. Prior to the procedure, every patient had to be visualizationed and approved for the procedure. During operation, the Olympus BF-1T160 (OLYMPUS OPTICAL Co., LTD. (Tokyo, Japan), Fujinon EB-530t (FUJIFILM Corporation Tokyo, Japan) and Pentax EB-1975K (HOYA Corporation Tokyo, Japan) devices and a 19-21 gauge and/or 22 gauge Wang (CONMED ® Corporation NY/USA, Matek® Medical Equipment Co. Ankara/TR) injection were used. 272 patients were analysed between the specified years and their results and follow-up were available. The procedure performed on 154 (56.61%) of 272 patients was diagnostic, while the procedure performed on 118 (43.38%) was not diagnostic. The sensitivity rate of transbronchial needle aspiration was 56.13%, specificity 100%, diagnostic efficiency 56.61%, negative predictive value 2.47% and positive predictive value 100%. The highest diagnostic efficiency was detected in lung cancer patients and 130 (60.4%) of 215 lung cancer patients were diagnosed with TBNA. There was a significant difference between the diagnosis of transbronchial needle aspiration (50%) and the diagnosis of forceps biopsy (26%) in patients with submucosal / peribronchial lesions.(p=0,013). In total of 272 patients analyzed, 6 (2.20%) had minor complications during the procedure. Transbronchial needle aspiration is a method with high diagnostic efficiency in intrathoracic lesions such as mediastinal lymphadenopathy and peribronchial lesions. Diagnostic efficacy is higher than forceps biopsy, especially in submucosal / peribronchial lesions, and we think it should be preferred together or before. It is also a method with high diagnostic and low complication rates and should be kept in mind as a safe method in intrathoracic lesions prior to other invasive procedures.
Transbronchial needle aspiration is a valuable diagnostic method used in sampling mediastinal lymph nodes and endobronchial, submucosal, peribronchial lesions. The aim of our study was to determine the diagnostic value of transbronchial needle aspiration in lung and mediastinal lesions. Between 2011 and 2018, transbronchial needle aspiration was performed in the Chest Diseases unit of the Faculty of Medicine of Trakya University and all the patients whose results could be reached were evaluated. Prior to the procedure, every patient had to be visualizationed and approved for the procedure. During operation, the Olympus BF-1T160 (OLYMPUS OPTICAL Co., LTD. (Tokyo, Japan), Fujinon EB-530t (FUJIFILM Corporation Tokyo, Japan) and Pentax EB-1975K (HOYA Corporation Tokyo, Japan) devices and a 19-21 gauge and/or 22 gauge Wang (CONMED ® Corporation NY/USA, Matek® Medical Equipment Co. Ankara/TR) injection were used. 272 patients were analysed between the specified years and their results and follow-up were available. The procedure performed on 154 (56.61%) of 272 patients was diagnostic, while the procedure performed on 118 (43.38%) was not diagnostic. The sensitivity rate of transbronchial needle aspiration was 56.13%, specificity 100%, diagnostic efficiency 56.61%, negative predictive value 2.47% and positive predictive value 100%. The highest diagnostic efficiency was detected in lung cancer patients and 130 (60.4%) of 215 lung cancer patients were diagnosed with TBNA. There was a significant difference between the diagnosis of transbronchial needle aspiration (50%) and the diagnosis of forceps biopsy (26%) in patients with submucosal / peribronchial lesions.(p=0,013). In total of 272 patients analyzed, 6 (2.20%) had minor complications during the procedure. Transbronchial needle aspiration is a method with high diagnostic efficiency in intrathoracic lesions such as mediastinal lymphadenopathy and peribronchial lesions. Diagnostic efficacy is higher than forceps biopsy, especially in submucosal / peribronchial lesions, and we think it should be preferred together or before. It is also a method with high diagnostic and low complication rates and should be kept in mind as a safe method in intrathoracic lesions prior to other invasive procedures.
Açıklama
Anahtar Kelimeler
Transbronşiyal İğne Aspirasyonu, Bronkoskopi, Mediastinal Lenfadenopati, İntratorasik Lezyon, Transbronchial Needle Aspiration Biopsy, Bronchoscopy, Mediastinal Lymphadenopaty, İntrathoracic Lesions
