Transoesophageal endoscopic ultrasound with bronchoscope: insights from an Australian Local Health District ahead of lung cancer screening

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Main Authors: Matthew Lindfield, Angus Lloyd, Vineeth George, Christopher Grainge, Scott Twaddell, David Arnold
Format: Artículo Open Access
Published: Wiley 2025
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author Matthew Lindfield
Angus Lloyd
Vineeth George
Christopher Grainge
Scott Twaddell
David Arnold
author_facet Matthew Lindfield
Angus Lloyd
Vineeth George
Christopher Grainge
Scott Twaddell
David Arnold
Matthew Lindfield
Angus Lloyd
Vineeth George
Christopher Grainge
Scott Twaddell
David Arnold
collection Wiley Open Access
contents Transoesophageal endoscopic ultrasound with bronchoscope: insights from an Australian Local Health District ahead of lung cancer screening Matthew Lindfield Angus Lloyd Vineeth George Christopher Grainge Scott Twaddell David Arnold Internal Medicine Journal AbstractBackgroundThe combined use of endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) and transoesophageal endoscopic ultrasound with bronchoscope‐guided fine‐needle aspiration (EUS‐B‐FNA) is preferred in the diagnosis and staging of non‐small cell lung cancer (NSCLC); however, there is limited utilisation of EUS‐B‐FNA in Australia. With a National Lung Cancer Screening program (NLCSP) commencing in 2025, additional diagnostics may be required by bronchoscopists.AimsWe describe the endoscopic model of care offered and outcomes achieved by Respiratory Physicians experienced in EUS‐B‐FNA practicing in a regional Australian tertiary referral hospital.MethodsAdult patients within the Hunter New England Local Health District (HNELDH) who underwent a diagnostic/staging EBUS‐TBNA or EUS‐B‐FNA procedures, as recorded in a prospectively collected procedural database from 2016 to 2022, were included.Results1564 patients (688 female), median age 68 years had a diagnostic or staging EBUS‐TBNA and/or EUS‐B‐FNA (1268 EBUS‐TBNA, 262 EUS‐B‐FNA and 34 combined). The diagnostic yield for procedures performed with an indication of suspected lung malignancy was as follows: EBUS‐TBNA: 75.5%, EUS‐B‐FNA: 85.7%, and combined procedure: 61.1%. Three major infectious complications were observed in EUS‐B‐FNA (1.15%) and two in EBUS‐TBNA (0.16%). These complications precede the institution's policy of pre‐procedural antibiotic prophylaxis started in 2021.ConclusionEUS‐B‐FNA can be performed safely by competent EBUS‐TBNA respiratory physicians provided that prospective data and complication monitoring are in place. 10.1111/imj.70113 http://creativecommons.org/licenses/by-nc-nd/4.0/
doi_str_mv 10.1111/imj.70113
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spellingShingle Transoesophageal endoscopic ultrasound with bronchoscope: insights from an Australian Local Health District ahead of lung cancer screening
Matthew Lindfield
Angus Lloyd
Vineeth George
Christopher Grainge
Scott Twaddell
David Arnold
Internal Medicine Journal
Transoesophageal endoscopic ultrasound with bronchoscope: insights from an Australian Local Health District ahead of lung cancer screening Matthew Lindfield Angus Lloyd Vineeth George Christopher Grainge Scott Twaddell David Arnold Internal Medicine Journal AbstractBackgroundThe combined use of endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) and transoesophageal endoscopic ultrasound with bronchoscope‐guided fine‐needle aspiration (EUS‐B‐FNA) is preferred in the diagnosis and staging of non‐small cell lung cancer (NSCLC); however, there is limited utilisation of EUS‐B‐FNA in Australia. With a National Lung Cancer Screening program (NLCSP) commencing in 2025, additional diagnostics may be required by bronchoscopists.AimsWe describe the endoscopic model of care offered and outcomes achieved by Respiratory Physicians experienced in EUS‐B‐FNA practicing in a regional Australian tertiary referral hospital.MethodsAdult patients within the Hunter New England Local Health District (HNELDH) who underwent a diagnostic/staging EBUS‐TBNA or EUS‐B‐FNA procedures, as recorded in a prospectively collected procedural database from 2016 to 2022, were included.Results1564 patients (688 female), median age 68 years had a diagnostic or staging EBUS‐TBNA and/or EUS‐B‐FNA (1268 EBUS‐TBNA, 262 EUS‐B‐FNA and 34 combined). The diagnostic yield for procedures performed with an indication of suspected lung malignancy was as follows: EBUS‐TBNA: 75.5%, EUS‐B‐FNA: 85.7%, and combined procedure: 61.1%. Three major infectious complications were observed in EUS‐B‐FNA (1.15%) and two in EBUS‐TBNA (0.16%). These complications precede the institution's policy of pre‐procedural antibiotic prophylaxis started in 2021.ConclusionEUS‐B‐FNA can be performed safely by competent EBUS‐TBNA respiratory physicians provided that prospective data and complication monitoring are in place. 10.1111/imj.70113 http://creativecommons.org/licenses/by-nc-nd/4.0/
title Transoesophageal endoscopic ultrasound with bronchoscope: insights from an Australian Local Health District ahead of lung cancer screening
topic Internal Medicine Journal
url https://onlinelibrary.wiley.com/doi/10.1111/imj.70113