Lung Cancer Clinical Trial
Official title:
Endobronchial Ultrasound Transbronchial Needle Aspiration (EBUS-TBNA) Versus Flexible 19G Endobronchial Ultrasound Transbronchial Needle (Flex 19G EBUS-TBNA) in the Assessment of Mediastinal and Hilar Lymphadenopathy: a Randomised Trial
Endobronchial ultrasound (EBUS) guided transbronchial needle aspiration (EBUS-TBNA) is an
excellent tool for sampling enlarged mediastinal and hilar lymph nodes, but only provides
needle aspirate samples which are often adequate for cytological examination only. More
advanced histopathological and immunocytopathological assessment of tissue samples, which is
particularly important in the diagnosis and staging of cancer, is often not possible with the
small cellular samples obtained by EBUS-TBNA. A new transbronchial nodal aspiration needle
(the Flex 19G EBUS-TBNA needle) has been developed with a larger needle diameter and more
flexibility at the distal end, allowing better access to some lymph nodes stations. This
needle can be passed down an EBUS scope and can hypothetically circumvent the deficiencies of
EBUS-TBNA highlighted above by providing tissue adequate for histological assessment rather
than cytological assessment alone.
This study aims to establish whether the use of the Flex 19G EBUS-TBNA needle can improve the
diagnostic yield of EBUS sampling procedures compared to the use of the conventional TBNA
needle, thereby allowing more accurate diagnoses and reducing the need repeat procedures or
more invasive surgical biopsies, without causing an increase in complication rates. Patients
with enlarged mediastinal and hilar lymph nodes referred for EBUS-TBNA will be randomised to
have their nodes sampled by either the EBUS-TBNA needle (conventional procedure) or the novel
Flex 19G EBUS-TBNA needle. The investigators hope to recruit 250 patients over a 24 month
period.
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