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23 June 2017 : Clinical Research  

Diagnostic Value of Video-assisted Mediastinoscopy and Endobronchial Ultrasound-guided Transbronchial Needle Aspiration for Mediastinal Lymphadenectasis without Pulmonary Abnormalities

Feng Zhu1ABCDEF, Dong-Chun Ma1BCD*, Ning Xu1BCD, Xian-Quan Xu1BCD, Li-Ping Lv2BCD, Lei Tang1BCD, Xian-Kui Zha2BCD, Jian-Ping Xu3BCD, Xu-Hong Min4BCD

DOI: 10.12659/MSM.900968

Med Sci Monit 2017; 23:3064-3070

Abstract

BACKGROUND: Mediastinal diseases are difficult to diagnose due to diverse origins and complex anatomical structure of the mediastinal tissues. The prospective study aimed to compare the diagnostic efficiency of video-assisted mediastinoscopy (VAM) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for mediastinal lesions without pulmonary abnormalities.

MATERIAL AND METHODS: We divided 100 mediastinal lymphadenectasis patients without pulmonary abnormalities into a VAM group and an EBUS group. The pathological results of each group were regarded as the endpoints. SPSS19.0 statistical software was used.

RESULTS: The diagnostic accuracy, sensitivity, and specificity of VAM were 96%, 97.4%, and 100%, respectively; those of EBUS-TBNA diagnosis were 62%, 87.1%, and 100%, respectively. There was a statistically significant difference in the diagnostic sensitivity of benign mediastinal lesions between the 2 groups (P<0.01). Compared with the EBUS group (62%), the accuracy in the VAM group was significantly higher (96%) (P<0.01).

CONCLUSIONS: We found that the diagnostic accuracy of VAM for mediastinal lymphadenectasis without pulmonary abnormalities is superior to that of EBUS. Therefore, for patients with mediastinal lymphadenectasis or mediastinal mass and without pulmonary abnormalities, mediastinoscopy is recommended as the first choice.

Keywords: Biopsy, Fine-Needle, Diagnosis, Mediastinoscopy

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750