Diagnostic yield of conventional trans-bronchial needle aspiration [TBNA] for subcarinal and right paratracheal nodes

Objective: to observe the diagnostic yield of conventional TBNA with EBUS-TBNA for right paratracheal and subcarinal nodes

Study Design: Observational / descriptive study

Place and Duration of study: This Study was conducted in Pulmonology Department of Services Institute of Medical Sciences [SIMS] Lahore from January 2013 to March 2015 after approval from ethical review committee

Materials and Methods: We prospectively enrolled patients with right Mediastinal and sub carinal lymph nodes for bronchoscopy and TBNA. Patients of both gender with significant [>1.5 cm] subcarinal and right paratracheal nodes or mass lesions were included in the study. All patients had conventional TBNA done with Smooth shot needle no.19 F via video bronchoscope under light sedation. Adequacy of the sample and definitive diagnosis either by Histopathology or cytology was noted

Results: Sixty patients including 27 male [45%] and 33 [55%] female had TBNA for Subcarinal or paratracheal nodes or mass lesions. Mean age was 50.31 + 14.3. Fifty four [90%] patients had the diagnosis on histopathology, cytology or tissue culture while 6 [10%] patients had non-diagnostic/inadequate samples. Leading diagnosis was Sarcoidosis 24 [44.4%] followed by NSCCA 11[20.3%], Tuberculosis 10 [18.5%], SCCA 7 [12.9%], and Endocrine Tumor 2 [3.7%]. Minor hemorrhage 6 [10 %] was managed by topical adrenaline

Conclusion: Conventional TBNA is useful easily available, cheap and safe diagnostic tool in patients with Sub- carinal and right Para-tracheal lymph nodes/mass lesions of >1.5 cm size

Need for chest tube after video assisted thoracoscopic [VATS] lung biopsy

To observe the effects of early removal of chest tube drain after video assisted thoracoscopic [VATS] lung biopsy. We prospectively evaluated the removal of chest tube drain at six hours or 24 hours after the VATS-lung biopsy in fifty consecutive patients with no evidence of air leak after the lung biopsy. Our results show that removal of chest tube drain at 6 hours was not associated with complications such pneumothorax, atelectasis or pleural effusion as compared to the 24 hours removal of the drain[p>0.05]. Early removal of chest tube drain is safe in patients where air leak has been documented to be absent. Since it was a non-randomized evaluation, further randomized study in our population is needed to confirm these findings