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ORIGINAL RESEARCH article
Front. Med.
Sec. Pulmonary Medicine
Volume 12 - 2025 |
doi: 10.3389/fmed.2025.1520690
Diagnostic value and safety of contact laser-assisted endotracheal ultrasound-guided tunnel drilling biopsy in mediastinal and hilar lymphadenopathy: A retrospective study
Provisionally accepted- Tianjin Medical University General Hospital, Tianjin, China
Introduction: Mediastinal and hilar lymphadenopathies are primarily diagnosed pathologically. Contact laser-assisted endobronchial ultrasound-guided tunnel drilling biopsy (EBUS-TDB), which uses a laser as a tunneling and incision tool, may yield more satisfactory specimens than conventional endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), thereby improving the diagnostic yield. This study aims to evaluate the diagnostic value and safety of contact laserassisted EBUS-TDB compared to EBUS-TBNA in the assessment of mediastinal and hilar lymph nodes. Methods: This retrospective study included patients who presented to our hospital between October 2022 and April 2024 with mediastinal or hilar lymph nodes of short diameter ≥ 1 cm on computed tomography (CT) or abnormally increased lymph node metabolism on positron emission tomography (PET)-CT. All patients underwent both EBUS-TBNA and EBUS-TDB procedures successively. Results: Overall, 278 patients were included in the study, and 244 cases were confirmed. The diagnostic rates (p-values) for EBUS-TDB and EBUS-TBNA in pulmonary and extrapulmonary malignancies, lymphoma, sarcoidosis, and lymph node tuberculosis were 96.6% vs. 76.3% (0.043), 100% vs. 67.7% (-), 88.9% vs. 31.1% (0.555), and 69.2% vs. 30.8% (0.049), respectively. No serious adverse events occurred during or after either procedure. Conclusion: Contact laser-assisted EBUS-TBNB demonstrates superior diagnostic performance compared to EBUS-TBNA for the evaluation of mediastinal or hilar lymph nodes, making it an alternative to EBUS-TBNA for enhanced diagnostic precision.
Keywords: Mediastinal lymphadenopathy, Endobronchial Ultrasound-Guided Tunnel Drilling Biopsy, Contact laser-assisted biopsy, diagnostic yield, Lymph node pathology
Received: 31 Oct 2024; Accepted: 14 Jan 2025.
Copyright: © 2025 Wenyu, Tian, Changqing, Yubao, Nansheng and Jing. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Wang Tian, Tianjin Medical University General Hospital, Tianjin, China
Wan Nansheng, Tianjin Medical University General Hospital, Tianjin, China
Feng Jing, Tianjin Medical University General Hospital, Tianjin, China
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