Evaluation of the Influence of the Experience and Training of EBUS-TBNA on Diagnostic Rate and Safety

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  • NAKAMURA Midori
    Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
  • UCHIMURA Keigo
    Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
  • HARA Sachika
    Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
  • OHIRA Hidenori
    Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
  • CHIBA Yosuke
    Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
  • NEMOTO Kazuki
    Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
  • HIGASHI Yasuyuki
    Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
  • TAHARA Masahiro
    Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
  • IKEGAMI Hiroaki
    Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
  • HIRANO Yoko
    Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
  • SAKAGAMI Kazuki
    Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
  • UYAMA Kazuhiro
    Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
  • SENNARI Konomi
    Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
  • TACHIWADA Takashi
    Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
  • KAWABATA Hiroki
    Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
  • NOGUCHI Shingo
    Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
  • YAMASAKI Kei
    Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
  • KAWANAMI Toshinori
    Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
  • YATERA Kazuhiro
    Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.

Bibliographic Information

Other Title
  • Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration（EBUS-TBNA）の経験やトレーニングが診断率および安全性に与える影響の検討
  • Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA)ノ ケイケン ヤ トレーニング ガ シンダンリツ オヨビ アンゼンセイ ニ アタエル エイキョウ ノ ケントウ

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Description

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been widely used in Japan. The guidelines of the American College of Chest Physicians has recommended that EBUS-TBNA should be performed by well-trained operators who can perform highly accurate procedures, but the indicators of the degree of experience and training are unclear. In our department, physicians who do not have enough experience perform EBUS-TBNA under the supervision of bronchoscopic instructors who have EBUS-TBNA techniques (Board Certified Member of the Japan Society for Respiratory Endoscopy) after guidance and training in EBUS-TBNA using a simulator as an operator and helper. In order to evaluate the influence of the experience and training of EBUS-TBNA on diagnostic accuracy and safety, we retrospectively compared the diagnostic accuracy and safety of EBUS-TBNA performed by physicians within one year of experience of EBUS-TBNA and those performed by physicians with more than one year of experience. A total of 111 cases (148 lesions) who were eventually diagnosed as having primary lung cancer and underwent EBUS-TBNA in our department between April 2014 and January 2016 were divided into two groups. Group A (43 cases, 57 lesions) was examined by third-year doctors within one year of experience of EBUS-TBNA, and group B (68 cases, 91 lesions) was examined by doctors with four or more years of experience and with more than one year of experience of EBUS-TBNA. Diagnostic rate, examination time, and complications were evaluated. There were no significant differences between the two groups in the diagnostic rate (A, 89.5% vs. B, 90.1%, P = 1.0) or examination time (A, 27 min vs. B, 23 min, P = 0.149), and no complications were observed in either group. This study suggests that even less-experienced physicians may safely perform EBUS-TBNA as well as moderately-experienced physicians with more than 1 year experience of EBUS-TBNA with similar diagnostic rates when proper training and supervision are supplied.

Journal

  • Journal of UOEH

    Journal of UOEH 41 (2), 179-184, 2019-06-01

    University of Occupational and Environmental Health, Japan

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