The use of convex probe endobronchial ultrasound-guided transbronchial needle aspiration in a pediatric population: A multicenter study

Christopher R. Gilbert*, Alexander Chen, Jason A. Akulian, Hans J. Lee, Momen Wahidi, A. Christine Argento, Nichole T. Tanner, Nicholas J. Pastis, Kassem Harris, Daniel Sterman, Jennifer W. Toth, Praveen R. Chenna, David Feller-Kopman, Lonny Yarmus

*Corresponding author for this work

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Introduction The presence of intrathoracic lymphadenopathy and mediastinal masses in the pediatric population often presents a diagnostic challenge. With limited minimally invasive methodologies to obtain a diagnosis, invasive sampling via mediastinoscopy or thoracotomy is often pursued. Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive, outpatient procedure that has demonstrated significant success in the adult population in the evaluation of such abnormalities. Within the pediatric literature there is limited data regarding the use of EBUS-TBNA. We report the first multicenter review of a pediatric population undergoing EBUS-TBNA procedures identifying the feasibility, safety, utility, and outcomes of this procedure. Methods All patients of 18 years of age or younger undergoing EBUS-TBNA at six major academic medical centers from the years 2007 through 2013 were reviewed. Data regarding procedural performance, outcomes, and complications were recorded. Results A total of 21 patients meeting the inclusion criteria were identified in six centers. The mean age of the cohort was 13.7 (±4.1) years. EBUS-TBNA provided adequate sampling in 20/21 (95%) of the cases with diagnostic material obtained in 10 (48%) cases. Eight patients (38%) underwent additional surgical procedures to confirm or obtain diagnostic tissue. Within our cohort, 13 patients (62%) were able to avoid invasive surgical biopsy procedures. No procedural or anesthesia related complications were identified. Conclusion We report the first multicenter study to date confirming the feasibility and utility of EBUS-TBNA in the pediatric population. Due to the low overall procedural risk of EBUS-TBNA, it should be considered as a potential first line diagnostic option for children presenting with mediastinal or hilar abnormalities but further prospective studies are needed.

Original languageEnglish (US)
Pages (from-to)807-815
Number of pages9
JournalPediatric Pulmonology
Volume49
Issue number8
DOIs
StatePublished - Jan 1 2014

Fingerprint

Multicenter Studies
Needles
Pediatrics
Population
Mediastinoscopy
Thoracotomy
Outpatients
Anesthesia
Prospective Studies
Biopsy
Safety

Keywords

  • EBUS-TBNA
  • bronchoscopy
  • lymphadenopathy
  • mediastinal mass
  • transbronchial needle aspiration

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

Cite this

Gilbert, Christopher R. ; Chen, Alexander ; Akulian, Jason A. ; Lee, Hans J. ; Wahidi, Momen ; Argento, A. Christine ; Tanner, Nichole T. ; Pastis, Nicholas J. ; Harris, Kassem ; Sterman, Daniel ; Toth, Jennifer W. ; Chenna, Praveen R. ; Feller-Kopman, David ; Yarmus, Lonny. / The use of convex probe endobronchial ultrasound-guided transbronchial needle aspiration in a pediatric population : A multicenter study. In: Pediatric Pulmonology. 2014 ; Vol. 49, No. 8. pp. 807-815.
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title = "The use of convex probe endobronchial ultrasound-guided transbronchial needle aspiration in a pediatric population: A multicenter study",
abstract = "Introduction The presence of intrathoracic lymphadenopathy and mediastinal masses in the pediatric population often presents a diagnostic challenge. With limited minimally invasive methodologies to obtain a diagnosis, invasive sampling via mediastinoscopy or thoracotomy is often pursued. Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive, outpatient procedure that has demonstrated significant success in the adult population in the evaluation of such abnormalities. Within the pediatric literature there is limited data regarding the use of EBUS-TBNA. We report the first multicenter review of a pediatric population undergoing EBUS-TBNA procedures identifying the feasibility, safety, utility, and outcomes of this procedure. Methods All patients of 18 years of age or younger undergoing EBUS-TBNA at six major academic medical centers from the years 2007 through 2013 were reviewed. Data regarding procedural performance, outcomes, and complications were recorded. Results A total of 21 patients meeting the inclusion criteria were identified in six centers. The mean age of the cohort was 13.7 (±4.1) years. EBUS-TBNA provided adequate sampling in 20/21 (95{\%}) of the cases with diagnostic material obtained in 10 (48{\%}) cases. Eight patients (38{\%}) underwent additional surgical procedures to confirm or obtain diagnostic tissue. Within our cohort, 13 patients (62{\%}) were able to avoid invasive surgical biopsy procedures. No procedural or anesthesia related complications were identified. Conclusion We report the first multicenter study to date confirming the feasibility and utility of EBUS-TBNA in the pediatric population. Due to the low overall procedural risk of EBUS-TBNA, it should be considered as a potential first line diagnostic option for children presenting with mediastinal or hilar abnormalities but further prospective studies are needed.",
keywords = "EBUS-TBNA, bronchoscopy, lymphadenopathy, mediastinal mass, transbronchial needle aspiration",
author = "Gilbert, {Christopher R.} and Alexander Chen and Akulian, {Jason A.} and Lee, {Hans J.} and Momen Wahidi and Argento, {A. Christine} and Tanner, {Nichole T.} and Pastis, {Nicholas J.} and Kassem Harris and Daniel Sterman and Toth, {Jennifer W.} and Chenna, {Praveen R.} and David Feller-Kopman and Lonny Yarmus",
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Gilbert, CR, Chen, A, Akulian, JA, Lee, HJ, Wahidi, M, Argento, AC, Tanner, NT, Pastis, NJ, Harris, K, Sterman, D, Toth, JW, Chenna, PR, Feller-Kopman, D & Yarmus, L 2014, 'The use of convex probe endobronchial ultrasound-guided transbronchial needle aspiration in a pediatric population: A multicenter study', Pediatric Pulmonology, vol. 49, no. 8, pp. 807-815. https://doi.org/10.1002/ppul.22887

The use of convex probe endobronchial ultrasound-guided transbronchial needle aspiration in a pediatric population : A multicenter study. / Gilbert, Christopher R.; Chen, Alexander; Akulian, Jason A.; Lee, Hans J.; Wahidi, Momen; Argento, A. Christine; Tanner, Nichole T.; Pastis, Nicholas J.; Harris, Kassem; Sterman, Daniel; Toth, Jennifer W.; Chenna, Praveen R.; Feller-Kopman, David; Yarmus, Lonny.

In: Pediatric Pulmonology, Vol. 49, No. 8, 01.01.2014, p. 807-815.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The use of convex probe endobronchial ultrasound-guided transbronchial needle aspiration in a pediatric population

T2 - A multicenter study

AU - Gilbert, Christopher R.

AU - Chen, Alexander

AU - Akulian, Jason A.

AU - Lee, Hans J.

AU - Wahidi, Momen

AU - Argento, A. Christine

AU - Tanner, Nichole T.

AU - Pastis, Nicholas J.

AU - Harris, Kassem

AU - Sterman, Daniel

AU - Toth, Jennifer W.

AU - Chenna, Praveen R.

AU - Feller-Kopman, David

AU - Yarmus, Lonny

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Introduction The presence of intrathoracic lymphadenopathy and mediastinal masses in the pediatric population often presents a diagnostic challenge. With limited minimally invasive methodologies to obtain a diagnosis, invasive sampling via mediastinoscopy or thoracotomy is often pursued. Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive, outpatient procedure that has demonstrated significant success in the adult population in the evaluation of such abnormalities. Within the pediatric literature there is limited data regarding the use of EBUS-TBNA. We report the first multicenter review of a pediatric population undergoing EBUS-TBNA procedures identifying the feasibility, safety, utility, and outcomes of this procedure. Methods All patients of 18 years of age or younger undergoing EBUS-TBNA at six major academic medical centers from the years 2007 through 2013 were reviewed. Data regarding procedural performance, outcomes, and complications were recorded. Results A total of 21 patients meeting the inclusion criteria were identified in six centers. The mean age of the cohort was 13.7 (±4.1) years. EBUS-TBNA provided adequate sampling in 20/21 (95%) of the cases with diagnostic material obtained in 10 (48%) cases. Eight patients (38%) underwent additional surgical procedures to confirm or obtain diagnostic tissue. Within our cohort, 13 patients (62%) were able to avoid invasive surgical biopsy procedures. No procedural or anesthesia related complications were identified. Conclusion We report the first multicenter study to date confirming the feasibility and utility of EBUS-TBNA in the pediatric population. Due to the low overall procedural risk of EBUS-TBNA, it should be considered as a potential first line diagnostic option for children presenting with mediastinal or hilar abnormalities but further prospective studies are needed.

AB - Introduction The presence of intrathoracic lymphadenopathy and mediastinal masses in the pediatric population often presents a diagnostic challenge. With limited minimally invasive methodologies to obtain a diagnosis, invasive sampling via mediastinoscopy or thoracotomy is often pursued. Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive, outpatient procedure that has demonstrated significant success in the adult population in the evaluation of such abnormalities. Within the pediatric literature there is limited data regarding the use of EBUS-TBNA. We report the first multicenter review of a pediatric population undergoing EBUS-TBNA procedures identifying the feasibility, safety, utility, and outcomes of this procedure. Methods All patients of 18 years of age or younger undergoing EBUS-TBNA at six major academic medical centers from the years 2007 through 2013 were reviewed. Data regarding procedural performance, outcomes, and complications were recorded. Results A total of 21 patients meeting the inclusion criteria were identified in six centers. The mean age of the cohort was 13.7 (±4.1) years. EBUS-TBNA provided adequate sampling in 20/21 (95%) of the cases with diagnostic material obtained in 10 (48%) cases. Eight patients (38%) underwent additional surgical procedures to confirm or obtain diagnostic tissue. Within our cohort, 13 patients (62%) were able to avoid invasive surgical biopsy procedures. No procedural or anesthesia related complications were identified. Conclusion We report the first multicenter study to date confirming the feasibility and utility of EBUS-TBNA in the pediatric population. Due to the low overall procedural risk of EBUS-TBNA, it should be considered as a potential first line diagnostic option for children presenting with mediastinal or hilar abnormalities but further prospective studies are needed.

KW - EBUS-TBNA

KW - bronchoscopy

KW - lymphadenopathy

KW - mediastinal mass

KW - transbronchial needle aspiration

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