Department of Pulmonary Medicine, Inonu University Medical Faculty, Turgut Ozal Medical Center, Malatya, Turkey.
Department of Thoracic Surgery, Inonu University Medical Faculty, Turgut Ozal Medical Center, Malatya, Turkey.
Int J Clin Pract. 2022 Jul 18;2022:7546012. doi: 10.1155/2022/7546012. eCollection 2022.
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been recognized as the first method of choice in the diagnosis of mediastinal and hilar lesions. Although the procedure is commonly used, there is no study assessing its contribution to the duration required for diagnosis and treatment. In this study, we aimed to determine the extent of diagnosis and treatment delays when using the EBUS-TBNA procedure and to address the possible factors contributing to these delays.
The demographic data, pathological diagnosis, need for additional procedures, symptoms, presenting complaints, and the time until the beginning of treatment were recorded retrospectively in all patients who had undergone EBUS-TBNA.
A total of 134 patients (mean age 60.7 ± 12 years, M/F: 78/56) were included. Delay of the patients was found in 60.4% ( = 81), delayed referral in 35.8% ( = 48), diagnosis delays in 84.3% ( = 113), treatment delays in 38.8% ( = 52), and total delay in 73.1% ( = 98) of the patients. A statistically significant association was found between referral delay and total delay with age groups (=0.006) and between patient delay and the presence of symptoms (=0.027). EBUS-TBNA was found to have the lowest effect among all delay parameters (: 0.104, < 0.001) in the regression analysis. When diagnosis times' subgroups were compared, EBUS-TBNA was found to have the least effect (correlation coefficient: 0.134, =0.004).
We found that approximately ¾ of the patients had a delay and this is not acceptable in real terms. Considering that the patient burden is increasing day by day, it is necessary to make a radical change in health care or a change in strategy in order to prevent delays. EBUS-TBNA, which is in the diagnosis delay subgroup, is less invasive and accelerates the process.
经支气管超声引导针吸活检术（EBUS-TBNA）已被公认为诊断纵隔和肺门病变的首选方法。虽然该操作已广泛应用，但尚无研究评估其对诊断和治疗所需时间的影响。本研究旨在确定使用 EBUS-TBNA 操作时诊断和治疗延迟的程度，并探讨导致这些延迟的可能因素。
回顾性分析所有接受 EBUS-TBNA 检查的患者的人口统计学数据、病理诊断、是否需要额外的操作、症状、主要症状和开始治疗的时间。
共纳入 134 例患者（平均年龄 60.7±12 岁，男/女：78/56）。60.4%（81 例）的患者存在延迟，其中 35.8%（48 例）为转诊延迟，84.3%（113 例）为诊断延迟，38.8%（52 例）为治疗延迟，73.1%（98 例）为总延迟。年龄组与转诊延迟和总延迟之间存在统计学显著相关性（=0.006），患者延迟与症状之间存在相关性（=0.027）。回归分析显示，EBUS-TBNA 是所有延迟参数中影响最小的（=0.104， < 0.001）。在诊断时间亚组比较中，EBUS-TBNA 的影响最小（相关系数：0.134，=0.004）。
我们发现约有 3/4 的患者存在延迟，这在实际情况中是不可接受的。考虑到患者负担日益增加，有必要在医疗保健方面进行根本性变革或改变策略，以防止延迟。作为诊断延迟亚组的 EBUS-TBNA 操作创伤较小且能加速诊断过程。
