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There is a need to promote more widespread use of TBNA for evaluating NSCLC
Since the introduction of flexible bronchoscopes in 1968,1 various ancillary related methods of sampling lung tissue have been developed to greatly expand the diagnostic capabilities of the procedure. Perhaps the most important innovation has been the development of needles with the ability to puncture the tracheobronchial wall, allowing the bronchoscopist to go beyond the barrier of the airways to obtain specimens from both hilar and mediastinal structures.
After the publication of Dr Ko-Pen Wang’s initial experience with transbronchial needle aspiration (TBNA) in the 1980s,2,3 it became clear that this technique had great potential in both the diagnosis and staging of lung cancer as well as other diseases. The only limiting requirement is that the lymph node must be in close contact with the airways, which is most frequently the case in patients with lung cancer. Despite numerous publications highlighting the safety and accuracy of this procedure, the technique is still underused by pulmonologists. Based on data compiled from Europe and the United States, it has been estimated that the percentage of pulmonologists using TBNA is between 11% and 30%.4–6
The three most often cited reasons for not performing TBNA are: (1) problems with the technique (30%); (2) a belief that TBNA is not useful …
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