BACKGROUND: The study aims to assess the efficacy and safety of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA) in patients with suspected lung cancer or isolated mediastinal lymphadenopathy. A retrospective analysis was performed on all patients who had an EBUS-TBNA over a ten year period.

METHODS: All consecutive patients who underwent EBUS-TBNA from Jan 2013 till Dec 2022 were included in the study. All EBUS-TBNA procedures were performed by a single operator, using an Olympus 21G needle. Patients whose final diagnosis was unknown were excluded from the final analysis.

RESULTS: A total of 968 procedures were performed over ten years. A total of 1232 lesions were sampled. The hit rate (percentage of samples that showed evidence of adequate sampling of the target lesions) was 91.6%. There were 17 complications (14 agitation, 1 desaturation, 1 jaw dislocation, 1 respiratory failure), out of the procedure had to be abandoned in 11 cases before samples could be obtained. The overall complication rate was 1.8%.  There were no reported fatalities.

The sensitivity of EBUS-TBNA was 90.8% for lung cancers, 90.5% for extra-thoracic cancers, 88.9% for sarcoidosis, 54.5% for tuberculosis and 20% for lymphoma. The specificity of EBUS-TBNA for diagnosing lung cancer was 100%.

CONCLUSIONS: This study demonstrates that EBUS-TBNA is a safe and accurate method for diagnosing and staging lung cancer, extra-thoracic cancers with lung/mediastinal involvement, and for granulomatous conditions.