Complications associated with endobronchial ultrasound-guided transbronchial needle aspiration: a nationwide survey by the Japan Society for Respiratory Endoscopy

Respiratory Research

Kazumitsu Ohmori¹  Shozo Fujino¹  Kazuya Fukuoka¹  Hiroshi Semba¹  Eiichi Suzuki¹  Shigeki Sato¹  Shinji Sasada¹  Yoshinori Okada¹  Yoshinobu Ohsaki¹  Motoi Aoe¹  Fumihiro Asano² 

[1] Safety Management Committee, Japan Society for Respiratory Endoscopy, Tokyo, Japan;Department of Pulmonary Medicine, Gifu Prefectural General Medical Center, 4-6-1 Noishiki, Gifu 500-8717, Japan

关键词: Survey;    Safety;    Pulmonary intervention;    Mortality;    Mediastinitis;    Lung cancer;    Infection;    Bronchoscopy;    Bronchoscopic ultrasound;    Breakage;   

Others  :  794697
DOI  :  10.1186/1465-9921-14-50

 received in 2013-02-08, accepted in 2013-05-07,  发布年份 2013

【 摘 要 】

Background

With the recent widespread use of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), there have been occasional reports on complications associated with its use. Previous reviews on EBUS-TBNA have been limited to studies by skilled operators, thus the results may not always be applicable to recent clinical practice. To assess the safety of EBUS-TBNA for the staging and diagnosis of lung cancer in Japan, a nationwide survey on its current usage status and complications associated with its use was conducted by the Japan Society for Respiratory Endoscopy (JSRE).

Methods

A questionnaire about EBUS-TBNA performed between January 2011 and June 2012 was mailed to 520 JSRE-accredited facilities.

Results

Responses were obtained from 455 facilities (87.5%). During the study period, EBUS-TBNA was performed in 7,345 cases in 210 facilities (46.2%) using a convex probe ultrasound bronchoscope, for 6,836 mediastinal and hilar lesions and 275 lung parenchymal lesions. Ninety complications occurred in 32 facilities. The complication rate was 1.23% (95% confidence interval, 0.97%-1.48%), with hemorrhage being the most frequent complication (50 cases, 0.68%). Infectious complications developed in 14 cases (0.19%) (Mediastinitis, 7; pneumonia, 4; pericarditis, 1; cyst infection, 1; and sepsis, 1). Pneumothorax developed in 2 cases (0.03%), one of which required tube drainage. Regarding the outcome of the cases with complications, prolonged hospitalization was observed in 14 cases, life-threatening conditions in 4, and death in 1 (severe cerebral infarction) (mortality rate, 0.01%). Breakage of the ultrasound bronchoscope occurred in 98 cases (1.33%) in 67 facilities (31.9%), and that of the puncture needle in 15 cases (0.20%) in 8 facilities (3.8%).

Conclusions

Although the complication rate associated with EBUS-TBNA was found to be low, severe complications, including infectious complications, were observed, and the incidence of device breakage was high. Since the use of EBUS-TBNA is rapidly expanding in Japan, an educational program for its safe performance should be immediately established.

【 授权许可】

   
2013 Asano et al.; licensee BioMed Central Ltd.

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