Introduction The introduction of endobronchial ultrasound has allowed visual sampling of nodes compared to the previous blind TBNA techniques. It was widely been used for patients with suspected lung. The purpose of our current study was to evaluate the usefulness of using a 2 needle technique compared to a single needle method in ebus sampling. The primary endpoint was to see the effect on the total number of biopsy passes, time between needle exchange and also total time taken to complete an ebus procedure.
Method 20 patients with mediastinal and hilar lymphadenopathy or suspected lung cancer in our institution were included in this prospective study. EBUS-TBNA was performed in all cases. 10 procedures were used using a 2 needle technique and 10 procedures were performed with single needle. Two trained bronchoscopists with 2 trained nurses performing the needle exchange and on site cytopathologist were present at the bronchoscopy giving an instant preliminary diagnosis.
Equal numbers of procedures were performed by each of the operators.
Results EBUS-TBNA was successfully performed in all 20 patients recruited. In the single needle technique the average number biopsy passes performed was 3.8 per ebus with an average needle changeover delay of 2 minutes 21 seconds and an average ebus time of 27 minutes. The two needle technique showed a greater number biopsy passes of 4.4 per ebus with a significantly reduced changeover needle time delay of 18 seconds per changeover and a reduction in overall ebus time to 21 minutes per procedure. All the procedures were uneventful without complications. All sample were labelled adequate by the histocytopathologist.
Conclusions Although the numbers performed in the study are small, there is enough evidence from our data to show a significant benefit in a 2 needle technique with a greater number of biopsy passes performed, reduced delay in needle changeover time and reduction in ebus procedure time. This is both beneficial to the patient with a reduced procedure time but also with a potential cost benefit if more procedures can be performed safely in a shorter time period.