Rapid on-site evaluation with BIOEVALUATOR during endobronchial ultrasound-guided transbronchial needle aspiration for diagnosing pulmonary and mediastinal diseases

Rapid on-site evaluation [ROSE] is used widely during endobronchial ultrasound-guided transbronchial needle aspiration [EBUS-TBNA]. BIOEVALUATOR is a device used for determining whether the tissues obtained by EBUS-TBNA are appropriate for a pathological diagnosis. This study describes our experience with ROSE using BIOEVALUATOR during EBUS-TBNA for diagnosing pulmonary and mediastinal diseases. We retrospectively evaluated the results of 35 patients who underwent EBUS-TBNA with BIOEVALUATOR between December 2011 and February 2013. For the diagnosis, the tissue areas were appearing white and red through BIOEVALUATOR are considered to be appropriate and inappropriate, respectively. We examined their medical records to obtain information concerning the examination of BIOEVALUATOR results of the patient's materials [white/red], the diagnosis yield, site and size of lymph nodes and number of needle passes. The median longest diameter of 40 lymph nodes [21 #7,13 #4R, 4 #4L and 2 #11] from 35 patients was 27.9 [range 12.4-50.6] mm and the median number of needle passes was 2 [range 1-5]. The definitive diagnosis was made by EBUS-TBNA in 28 of 35 patients, by thoracotomy in one patient and BIOEVALUATOR results were white and lymphocytes were seen in the rest six patients. The BIOEVALUATOR results of other patients without accurate diagnosis were left indefinitive. Finally, the six patients were judged as having benign lymphadenopathy because the lymph node size on computed tomography decreased or remained stable after for at least 8 months. Checking aspirated samples using BIOEVALUATOR appears useful for determining their adequacy for pathological diagnosis

Risk factor for occlusion of central venous access port system in colon cancer patients

<b>Purpose</b>: It is critical to reduce complications associated with the central venous access port (CV-port) system for patients who were treated with chemotherapy or palliative care. <b>Methods</b>: From October 2006 to December 2011, 68 colon cancer patients who were treated with outpatient chemotherapy via a CV-port in the Center for Clinical Oncology, Okayama University Hospital, were analyzed retrospectively. <b>Results</b>: CV-port related complications occurred in 20 (29.4%) patients. No blood could be aspirated in 15 patients when treated via a CV-port. Among the patients with no blood aspiration from their CV-port, ten cases had no complications other than failure of blood aspiration, and anticancer agents have been successfully administered. However, the other five patients had their CV-port system replaced due to complications. Subclavian and left side insertions were the risk factors for catheter occlusion or inability to aspirate blood. <b>Conclusion</b>: Medical staffs should be aware that approximately one-third of the cases with no blood aspiration potentially have troubles with their CV-ports that need to be replaced.