Mohan Anant, Madan Karan, Hadda Vijay, Mittal Saurabh, Suri Tejas, Shekh Irfan, Guleria Randeep, Khader Abdul, Chhajed Prashant, Christopher Devasahayam J, Swarnakar Rajesh, Agarwal Ritesh, Aggarwal Ashutosh Nath, Aggarwal Shubham, Agrawal Gyanendra, Ayub Irfan Ismail, Bai Muniza, Baldwa Bhvya, Chauhan Abhishek, Chawla Rakesh, Chopra Manu, Choudhry Dhruva, Dhar Raja, Dhooria Sahajal, Garg Rakesh, Goel Ayush, Goel Manoj, Goyal Rajiv, Gupta Nishkarsh, Manjunath B G, Iyer Hariharan, Jain Deepali, Khan Ajmal, Kumar Raj, Koul Parvaiz A, Lall Ajay, Arunachalam M, Madan Neha K, Mehta Ravindra, Loganathan N, Nath Alok, Nangia Vivek, Nene Amita, Patel Dharmesh, Pattabhiraman V R, Raja Arun, Rajesh Benin, Rangarajan Amith, Rathi Vidushi, Sehgal Inderpaul Singh, Shankar Sujay H, Sindhwani Girish, Singh Pawan K, Srinivasan Arjun, Talwar Deepak, Thangakunam Balamugesh, Tiwari Pawan, Tyagi Rahul, Chandra V Naren, Sharada V, Vadala Rohit, Venkatnarayan Kavitha
Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India.
Institute of Pulmonology, Allergy and Asthma Research, Calicut, India.
Lung India. 2023 Jul-Aug;40(4):368-400. doi: 10.4103/lungindia.lungindia_510_22.
Over the past decade, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has become an indispensable tool in the diagnostic armamentarium of the pulmonologist. As the expertise with EBUS-TBNA has evolved and several innovations have occurred, the indications for its use have expanded. However, several aspects of EBUS-TBNA are still not standardized. Hence, evidence-based guidelines are needed to optimize the diagnostic yield and safety of EBUS-TBNA. For this purpose, a working group of experts from India was constituted. A detailed and systematic search was performed to extract relevant literature pertaining to various aspects of EBUS-TBNA. The modified GRADE system was used for evaluating the level of evidence and assigning the strength of recommendations. The final recommendations were framed with the consensus of the working group after several rounds of online discussions and a two-day in-person meeting. These guidelines provide evidence-based recommendations encompassing indications of EBUS-TBNA, pre-procedure evaluation, sedation and anesthesia, technical and procedural aspects, sample processing, EBUS-TBNA in special situations, and training for EBUS-TBNA.
在过去十年中，支气管内超声引导下经支气管针吸活检术（EBUS-TBNA）已成为肺科医生诊断工具库中不可或缺的工具。随着EBUS-TBNA专业技术的发展以及出现了多项创新，其应用指征不断扩大。然而，EBUS-TBNA的几个方面仍未标准化。因此，需要基于证据的指南来优化EBUS-TBNA的诊断率和安全性。为此，成立了一个来自印度的专家工作组。进行了详细而系统的检索，以提取与EBUS-TBNA各方面相关的文献。采用改良的GRADE系统来评估证据水平并确定推荐强度。经过几轮在线讨论和为期两天的面对面会议后，最终建议在工作组达成共识的基础上制定。这些指南提供了基于证据的建议，涵盖EBUS-TBNA的指征、术前评估、镇静与麻醉、技术与操作方面、样本处理、特殊情况下的EBUS-TBNA以及EBUS-TBNA培训。
